Management and Prognosis of Acute Post-Cataract Surgery Endophthalmitis: A 10-Year Retrospective Analysis in Eastern China
Abstract
:1. Introduction
2. Results
2.1. Incidence and Clinical Characteristics
2.2. Factors Affecting Visual Outcomes
2.3. Culture Results
2.4. Adjunct Use of Intravitreal Corticosteroids
2.5. Systemic Antibiotic Use
3. Discussion
4. Materials and Methods
4.1. Study Population
4.2. Treatment
4.3. Vitreous/Aqueous Sample Collection and Culture
4.4. Data Collection
4.5. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Total (n = 56) | Final BCVA ≥ 20/70 | Final BCVA < 20/70 | p-Value |
---|---|---|---|---|
(n = 21) | (n = 35) | |||
Age (years) | 70 (59, 74) | 63 (54, 75) | 71 (60, 73) | 0.63 |
Sex/male | 27 (48.2%) | 12 (57.1%) | 15 (42.8%) | 0.3 |
Left eye | 25 (44.6%) | 12 (57.1%) | 13 (37.1%) | 0.14 |
Time from cataract surgery to onset of endophthalmitis (days) | 4 (1, 11) | 7 (3, 16) | 3 (1, 8) | 0.008 |
Time from onset to initial IVAs (days) | 3 (2, 7) | 2 (2, 4) | 5 (2, 9) | 0.09 |
Diabetes mellitus | 10 (17.8%) | 2 (9.5%) | 8 (22.8%) | 0.21 |
Presence of corneal edema | 30 (53.6%) | 10 (47.6%) | 20 (57.1%) | 0.49 |
Presence of hypopyon | 20 (35.7%) | 6 (28.6%) | 14 (40.0%) | 0.39 |
Positive culture | 18 (32.1%) | 5 (23.8%) | 13 (37.1%) | 0.3 |
High virulence of pathogens | 8 (14.3%) | 0 (0.0%) | 8 (22.8%) | 0.02 |
Initial treatment with PPV + IVAs | 44 (78.6%) | 16 (76.2%) | 28 (80.0%) | 0.74 |
Use of intravitreal corticosteroids | 15 (26.8%) | 6 (28.6%) | 9 (25.7%) | 0.82 |
Use of systematic antibiotics | 46 (82.1%) | 16 (76.2%) | 30 (85.7%) | 0.37 |
Total systemic antibiotic duration (days) | 3 (2, 5) | 3 (1, 4) | 3 (2, 7) | 0.13 |
Initial BCVA (logMAR) | 2.3 (1.8, 2.7) | 2 (1.0, 2.3) | 2.3 (2, 2.7) | 0.03 |
Variable | Standardized β | p-Value |
---|---|---|
Time from cataract surgery to onset of endophthalmitis (days) | −0.078 | 0.506 |
Time from onset to initial IVAs (days) | 0.383 | <0.001 |
Infected with highly virulent pathogens | 0.286 | 0.018 |
Initial BCVA (logMAR) | 0.407 | <0.001 |
Pathogens from the Aqueous | Pathogens from the Vitreous | |
---|---|---|
Total | 31 | 48 |
Negative | 22 | 33 |
Coagulase-negative staphylococci | 6 | 7 |
Staphylococcus aureus | 1 | 1 |
Streptococcus dysgalactiae | 0 | 1 |
Bacillus cereus | 0 | 1 |
Pseudomonas aeruginosa | 1 | 2 |
Escherichia coli | 1 | 1 |
Aspergillus + Coagulase-negative staphylococci | 0 | 1 |
α-hemolytic streptococci + Coagulase-negative staphylococci | 0 | 1 |
Variable | Highly Virulent Pathogen (n = 8) | Less Virulent Pathogen (n = 48) | p-Value |
---|---|---|---|
Age (years) | 70 (57, 74) | 69 (62, 77) | 0.61 |
Sex/male | 3 (37.5%) | 24 (50.0%) | 0.79 |
Left eye | 2 (25.0%) | 23 (47.9%) | 0.41 |
Time from cataract surgery to onset of endophthalmitis (days) | 1.5 (1, 4) | 5 (2, 13) | 0.04 |
Time from onset to initial IVAs (days) | 1 (0.25, 2) | 4 (2, 7) | <0.001 |
Diabetes mellitus | 2 (25.0%) | 8 (16.7%) | 0.94 |
Presence of corneal edema | 6 (75.0%) | 24 (50.0%) | 0.35 |
Presence of hypopyon | 6 (75.0%) | 14 (29.2%) | 0.04 |
Initial BCVA (logMAR) | 2.5 (2.3, 2.7) | 2.3 (1.5, 2.7) | 0.08 |
Final BCVA (logMAR) | 2.5 (1.0, 3.0) | 0.9 (0.3, 2.3) | 0.02 |
Final BCVA ≥ 20/70 | 0 (0.0%) | 21 (43.8%) | 0.02 |
Category | Corticosteroids Group (n = 15) | Non-Corticosteroids Group (n = 41) | p-Value |
---|---|---|---|
Age (years) | 70 (53, 74) | 68 (59, 74) | 0.89 |
Sex/male | 9 (60.0%) | 18 (43.9%) | 0.29 |
Left eye | 9 (60.0%) | 16 (39.0%) | 0.16 |
Time from cataract surgery to onset of endophthalmitis (days) | 2 (1, 7) | 5 (2, 12) | 0.11 |
Time from onset to initial IVAs (days) | 2 (1, 7) | 4 (2, 7) | 0.33 |
Diabetes mellitus | 4 (26.7%) | 6 (14.6%) | 0.52 |
Presence of corneal edema | 14 (93.3%) | 16 (39.0%) | <0.001 |
Presence of hypopyon | 8 (53.3%) | 12 (29.3%) | 0.10 |
Positive culture | 4 (26.7%) | 14 (34.2%) | 0.84 |
Highly virulent pathogen | 2 (13.3%) | 6 (14.6%) | 1.00 |
Initial treatment with PPV + IVAs | 13 (86.7%) | 31 (85.4%) | 0.37 |
Use of systematic antibiotics | 15 (100.0%) | 31 (75.6%) | 0.048 |
Total systemic antibiotic duration (days) | 5 (3, 7) | 3. (0.5, 4.5) | 0.03 |
Initial BCVA (logMAR) | 2.7 (2.3, 2.7) | 2.3 (1.6, 2.3) | 0.03 |
Final BCVA (logMAR) | 1.3 (0.3, 2.3) | 1.1 (0.4, 2.3) | 0.56 |
Final BCVA ≥ 20/70 | 6 (40.0%) | 15 (36.6%) | 0.82 |
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Zhang, X.; Chen, Z.; Li, X.; Zhou, Z.; Boost, M.; Huang, T.; Zhou, X. Management and Prognosis of Acute Post-Cataract Surgery Endophthalmitis: A 10-Year Retrospective Analysis in Eastern China. Antibiotics 2023, 12, 1670. https://doi.org/10.3390/antibiotics12121670
Zhang X, Chen Z, Li X, Zhou Z, Boost M, Huang T, Zhou X. Management and Prognosis of Acute Post-Cataract Surgery Endophthalmitis: A 10-Year Retrospective Analysis in Eastern China. Antibiotics. 2023; 12(12):1670. https://doi.org/10.3390/antibiotics12121670
Chicago/Turabian StyleZhang, Xiuwen, Zhi Chen, Xiaoxia Li, Zimei Zhou, Maureen Boost, Taomin Huang, and Xingtao Zhou. 2023. "Management and Prognosis of Acute Post-Cataract Surgery Endophthalmitis: A 10-Year Retrospective Analysis in Eastern China" Antibiotics 12, no. 12: 1670. https://doi.org/10.3390/antibiotics12121670