Skip to main content

Advertisement

SpringerLink
Log in

Endophthalmitis following cataract surgery in Southwest Finland from 1987 to 2000

  • Clinical Investigation
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the incidence, causes, prevention, treatment and outcome of postoperative endophthalmitis (POE) following cataract surgery in south-west Finland from 1987 to 2000.

Methods

We reviewed the medical records of all patients with POE following cataract surgery treated in the hospital district of Southwest Finland from 1 January 1987 to 31 December 2000. Population-based annual incidence rates of cataract extractions and POE were calculated using the corrected population statistics of the hospital district.

Results

There were 29,350 cataract procedures during the 14-year period. POE developed in 47 patients. The annual incidence of cataract operations increased more than fivefold from 1987 (155 per 100,000 population) to the maximum in 1999 (930 per 100,000 population), whereas the annual incidence of postcataract endophthalmitis decreased from the maximum of 11.1 per 1,000 cataract extractions (1.91 per 100,000 population) in 1988 to the minimum of 0–0.6 per 1,000 cataract extractions in 1999 and 2000. POE occurred statistically significantly more frequently after extracapsular cataract extraction (ECCE) than after phacoemulsification (Phaco) (P=0.0006). Gram-positive bacteria were the most frequent cause of acute POE and Propionibacterium acnes was the most frequent reason for delayed-onset POE. The complications of POE after cataract surgery included visual loss to below 0.05 (25.5% of affected eyes), opacification of the cornea (21.3%), secondary cataract (40.4%), increase in intraocular pressure (29.8%), vitreous clouding (63.8%), and retinal detachment (6.4%). Nearly one half of the eyes achieved final visual acuity of 0.5 or better.

Conclusions

During the 14-year study period there was a shift from ECCE to Phaco, a fivefold increase in cataract extractions, and a decrease in the annual incidence of POE from 5.5–11.1 to 0–0.6 per 1,000 operations. Phaco was associated with a lower risk of POE than ECCE.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Beigi B, Westlake W, Mangelschots E (1997) Peroperative microbial contamination of anterior chamber aspirates during extracapsular cataract extraction and phacoemulsification. Br J Ophthalmol 81:953–955

    PubMed  CAS  Google Scholar 

  2. Central Statistical Office of Finland. Corrected population Statistics, Serial VI, volumes 84–96, years 1989–2001

  3. Doft BH (1998) The endophthalmitis vitrectomy study. In: Kertes PJ, Conway MD (eds) Clinical trials in ophthalmology: a summary and practice guide. Lippincott, Williams & Wilkins, Philadelphia, pp 97–111

    Google Scholar 

  4. Egger SF, Huber-Spitzy V, Skorpik C, Weghaupt H, Scholda C, Arocker-Mettinger E, Schneider B, Grabner G (1994) Different techniques of extracapsular cataract extraction: bacterial contamination during surgery. Graefe Arch Clin Exp Ophthalmol 232:308–311

    Article  CAS  Google Scholar 

  5. Endophthalmitis Vitrectomy Study Group (1995) Results of the endophthalmitis vitrectomy study: a randomised trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Arch Ophthalmol 113:1479–1496

    Google Scholar 

  6. Fox GM, Joondeph BC, Flynn HW, Pflugfelder SC, Roussel TJ (1991) Delayed-onset pseudophakic endophthalmitis. Am J Ophthalmol 111:163–173

    PubMed  CAS  Google Scholar 

  7. Galand A, Van Oye R, Budo C, Goes F (1985) Results of implantation in the capsular bag: a short term review of 1588 cases. Trans Ophthalmol Soc UK 104:563–566

    PubMed  Google Scholar 

  8. Heaven CJ, Mann PJ, Boase DL (1992) Endophthalmitis following extracapsular cataract surgery: a review of 32 cases. Br J Ophthalmol 76:419–432

    Article  PubMed  CAS  Google Scholar 

  9. Irvine DW, Flynn HW, Miller D (1992) Endophthalmitis caused by gram-negative organisms. Arch Ophthalmol 110:1450–1454

    PubMed  CAS  Google Scholar 

  10. Kraft MC, Sanders DR (1990) Incidence of retinal detachment following posterior chamber intraocular lens surgery. J Cataract Refract Surg 16:477–480

    PubMed  Google Scholar 

  11. Leong JK, Shah R, McCluskey PJ, Benn RA, Taylor RF (2002) Bacterial contamination of the anterior chamber during phacoemulsification cataract surgery. J Cataract Refract Surg 28:826–833

    Article  PubMed  Google Scholar 

  12. Mamalis N, Kearsley L, Brinton E (2002) Postoperative endophthalmitis. Curr Opin Ophthalmol 13: 14–18

    Article  PubMed  Google Scholar 

  13. Mayer E, Cadman D, Ewings P, Twomey JM, Gray RH, Claridge KG, Hakin KN, Bates AK (2003) A 10 year retrospective survey of cataract surgery and endophthalmitis in a single eye unit: injectable lenses lower the incidence of endophthalmitis. Br J Ophthalmol 87:867–869

    Article  PubMed  CAS  Google Scholar 

  14. Mistlberger A, Ruckhofer J, Raithel E, Müller M, Alzner E, Egger SF, Grabner G (1997) Anterior chamber contamination during cataract surgery with intraocular lens implantation. J Cataract Refract Surg 23:1064–1069

    PubMed  CAS  Google Scholar 

  15. Montan PG, Koranyi G, Setterquist HE, Stridh A, Philipson BT, Wiklund K (1998) Endophthalmitis after cataract surgery: risk factors relating to technique and events of the operation and patient history. A retrospective case-control study. Ophthalmology 105:2171–2177

    Article  CAS  Google Scholar 

  16. Montan P, Lundstrom M, Stenevi U, Thorburn W (2002) Endophthalmitis following cataract surgery in Sweden. The 1998 national prospective survey. Acta Ophthalmol Scand 80:258–261

    Article  PubMed  Google Scholar 

  17. Norregaard JC, Thoning H, Bernth-Petersen P, Andersen TF, Javitt JC, Anderson GF (1997) Risk of endophthalmitis after cataract extraction: results from the International Cataract Surgery Outcomes study. Br J Ophthalmol 81:102–106

    Article  PubMed  CAS  Google Scholar 

  18. Powe NR, Schein OD, Gieser SC, Tielsch JM, Luthra R, Javitt J, Steinberg EP (1994) Synthesis of the literature on visual acuity and complications following cataract extraction with intraocular lens implantation. Arch Ophthalmol 112:239–252

    PubMed  CAS  Google Scholar 

  19. Schmitz S, Dick HB, Krummenauer F (1999) Endopthalmitis in cataract surgery: results of a German survey. Ophthalmology 106:1869–1877

    Article  PubMed  CAS  Google Scholar 

  20. Semmens JB, Li J, Morlet N, Ng J (2003) Trends in cataract surgery and postoperative endophthalmitis in Western Australia (1980–1998): the Endophthalmitis Population Study of Western Australia. Clin Exp Ophthalmol 31:213–219

    Article  Google Scholar 

  21. Sheets JH (1987) A step beyond ECCE. CLAO J 13:67–70

    PubMed  CAS  Google Scholar 

  22. Somani S, Grinbaum A, Slomovic AR (1997) Postoperative endophthalmitis: incidence, predisposing surgery, clinical course and outcome. Can J Ophthalmol 32:303–310

    PubMed  CAS  Google Scholar 

  23. Speaker MG, Milch FA, Shah MK (1991) Role of external bacterial flora in the pathogenesis of acute postoperative endophthalmitis. Ophthalmology 98:639–949

    PubMed  CAS  Google Scholar 

  24. Tervo T, Ljungberg P, Kautiainen T, Puska P, Lehto I, Raivio I, Järvinen E, Kuusela P, Tarkkanen A (1999) Prospective evaluation of external ocular microbial growth and aqueous humor contamination during cataract surgery. J Cataract Refract Surg 25:65–71

    Article  PubMed  CAS  Google Scholar 

  25. Versteegh MFL, van Rij G (2000) Incidence of endophthalmitis after cataract surgery in the Netherlands. Doc Ophthalmol 100:1–6

    Article  PubMed  CAS  Google Scholar 

  26. Wong TY, Chee S-P (2004) The epidemiology of acute endophthalmitis after cataract surgery in an Asian population. Ophthalmology 111:699–705

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported in part by Turku University Hospital Research Fund, Turku, Finland.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, University of Turku, 20520, Turku, Finland

    Timo T. Haapala, Laura Nelimarkka & K. Matti Saari

  2. Department of Computational Engineering, Helsinki University of Technology, Helsinki, Finland

    Jukka M. Saari

  3. Department of Statistics, University of Turku, Turku, Finland

    Virpi Ahola

Authors
  1. Timo T. Haapala
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Laura Nelimarkka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jukka M. Saari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Virpi Ahola
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Matti Saari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K. Matti Saari.

Additional information

None of the authors has a financial or proprietary interest in any material or method mentioned.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Haapala, T.T., Nelimarkka, L., Saari, J.M. et al. Endophthalmitis following cataract surgery in Southwest Finland from 1987 to 2000. Graefe's Arch Clin Exp Ophthalmo 243, 1010–1017 (2005). https://doi.org/10.1007/s00417-005-1190-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-005-1190-1

Keywords

Search

Navigation