Delayed- Versus Acute-Onset Endophthalmitis After Cataract Surgery

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• 作者：Anita R. Shirodkar ; ^{ashirodkar@med.miami.edu}  ; [Author Vitae] ; Avinash Pathengay  ; [Author Vitae] ; Harry W. Flynn Jr ; Thomas A. Albini ; Audina M. Berrocal ; Janet L. Davis ; Geeta A. Lalwani ; Timothy G. Murray ; William E. Smiddy ; Darlene Miller
• 刊名：American Journal of Ophthalmology
• 出版年：2012
• 出版时间：March 2012
• 年：2012
• 卷：153
• 期：3
• 页码：391-398.e2
• 全文大小：2261 K

文摘

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Purpose

To report a large consecutive case series of patients who developed delayed-onset and acute-onset endophthalmitis after cataract surgery.

Design

Retrospective consecutive case series.

Methods

The current study is a retrospective consecutive case series of patients treated between January 2000 and December 2009 for culture-proven endophthalmitis after cataract surgery. The study defined 2 groups after cataract surgery: acute-onset endophthalmitis (? weeks after surgery) and delayed-onset endophthalmitis (>6 weeks after surgery).

Results

A total of 118 patients met study criteria; cases included 26 delayed-onset cases and 92 acute-onset cases. The following clinical features and outcomes occurred in delayed- vs acute-onset cases: 1) the presenting visual acuity was ?/200 in 31 % vs 89 % ; 2) hypopyon was found in 46 % vs 80 % ; 3) the most frequent isolate was <em>Propionibacterium acnesem> (11/26) vs coagulase-negative <em>Staphylococcusem> (57/92); and 4) patients with the most frequent isolate achieved a visual outcome of ?0/100 in 91 % vs 56 % . In delayed-onset cases, the intraocular lens was removed or exchanged in 19 of 26 cases (73 % ). Of these 19 cases, 13 achieved a visual outcome of ?0/100.

Conclusions

Patients with delayed-onset endophthalmitis generally presented with better initial visual acuities, had a lower frequency of hypopyon, and had better visual outcomes compared to acute-onset patients. <em>Propionibacterium acnesem> and coagulase-negative <em>Staphylococcusem> species were the most common organisms cultured in delayed- and acute-onset categories, respectively, and were associated with the best visual acuity outcomes in each group.