Endophthalmitis rates after intraocular procedures declined over past 2 decades
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Key takeaways:
- A study found a steady decrease in endophthalmitis rates over time with all procedures.
- Prompt vitrectomy is used less frequently as a primary treatment.
A study covering a large U.S. database over 22 years found a steady decrease in the rate of endophthalmitis after intraocular procedures.
The analysis, published in JAMA Ophthalmology, also showed that the use of prompt vitrectomy as the primary treatment has been gradually declining over time in favor of tap and inject.
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The study included data from surgeries and intravitreal injections for cataract, glaucoma retinal pathologies and corneal transplantation. Data were extracted from Optum’s deidentified Clinformatics Data Mart, a large U.S. medical claims database covering data from 2000 to 2022. The analysis included 5,827,809 intraocular procedures from 2,124,964 patients.
Endophthalmitis was reported in 4,305 patients, accounting for an overall rate of 0.07%. The overall yearly rate of endophthalmitis decreased over time, from 0.2% in 2000 to 0.05% in 2022.
When specific procedures were reviewed, the overall rate of endophthalmitis for cataract surgery was 0.08%, declining from 0.22% in 2000 to 0.05% in 2022. Intravitreal injections had an overall endophthalmitis rate of 0.06%, the lowest across all procedures, declining from 0.28% in 2005, when these injections were still a new and relatively uncommon procedure, to 0.04% in 2022.
The proportion of cases treated by vitrectomy decreased over time, from 48.6% in 2003 to 11.6% in 2021. Several other studies, the authors noted, confirm that prompt vitrectomy is being used less frequently than in the past.
“Additional work will need to be done to evaluate the reason behind this change in management and the clinical impact this change in management has on outcomes,” the authors wrote.
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