Journal of Cataract & Refractive Surgery
Volume 35, Issue 4 , Pages 629-636 , April 2009

Incidence of post-cataract endophthalmitis at Aravind Eye Hospital: Outcomes of more than 42 000 consecutive cases using standardized sterilization and prophylaxis protocols

Received 28 November 2008 ,Revised 9 January 2009 ,Accepted 12 January 2009.

References 

  1. National Control & Prevention of Blindness Data. Monthwise performance of cataract surgery during 2008 2009. New Delhi, India: Ministry of Health & Family Welfare, Government of India; 2009;Available from http://mohfw.nic.in/Cataract%20Performance%20updated.xlsAccessed January 14, 2009
  2. Miller JJ, Scott IU, Flynn HW, Smiddy WE, Newton J, Miller D. Acute-onset endophthalmitis after cataract surgery (2000–2004): incidence, clinical settings, and visual acuity outcomes after treatment. Am J Ophthalmol. 2005;139:983–987
  3. Bell CM, Hatch WV, Cernat G, Urbach DR. Surgeon volumes and selected patient outcomes in cataract surgery. Ophthalmology. 2007;114:405–410
  4. Chandra SR. Global blindness; Vision 2020: the right to sight. [editorial] Arch Ophthalmol. 2008;126:1457
  5. Foster A, Resnikoff S. The impact of Vision 2020 on global blindness. Eye. 2005;19:1133–1135
  6. Murthy GVS, Gupta SK, John N, Vashist P. Current status of cataract blindness and Vision 2020: the right to sight initiative in India. Indian J Ophthalmol. 2008;56:489–494Available at: http://www.ijo.in/temp/IndianJOphthalmol566489-4685979_130059.pdf
  7. Resnikoff S, Pascolini D, Etya'ale D, Kocur I, Pararajasegaram R, Pokharel GP, et al. Global data on visual impairment in the year 2002. Bull World Health Organ. 2004;82:844–851Available at: http://www.who.int/bulletin/volumes/82/11/en/844arabic.pdfAccessed January 14, 2009
  8. The Eye Diseases Prevalence Research Group. Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol. 2004;122:477–485
  9. Natchiar G, Robin AL, Thulasiraj R, Krishnaswamy S. Attacking the backlog of India's curable blind; the Aravind Eye Hospital model. Arch Ophthalmol. 1994;112:987–993
  10. Venkatesh R, Tan CSH, Singh GP, Veena K, Krishnan KT, Ravindran RD. Safety and efficacy of manual small incision cataract surgery for brunescent and black cataracts. In press. Eye. 2009;
  11. Gupta A, Gupta V, Gupta A, Dogra MR, Pandav SS, Ray P, et al. Spectrum and clinical profile of post cataract surgery endophthalmitis in North India. Indian J Ophthalmol. 2003;51:139–145Available at: http://www.ijo.in/temp/IndianJOphthalmol512139-4696518_130245.pdfAccessed January 15, 2009
  12. Malhotra S, Mandal P, Patanker G, Agrawal D. Clinical profile and visual outcome in cluster endophthalmitis following cataract surgery in Central India. Indian J Ophthalmol. 2008;56:157–158Available at: http://www.ijo.in/article.asp?issn=0301-4738;year=2008;volume=56;issue=2;spage=157;epage=158;aulast=MalhotraAccessed January 15, 2009
  13. Mollan SP, Gao A, Lockwood A, Durrani OM, Butler L. Postcataract endophthalmitis: incidence and microbial isolates in a United Kingdom region from 1996 through 2004. J Cataract Refract Surg. 2007;33:265–268erratum, 759
  14. Montan P, Lundström M, Stenevi U, Thorburn W. Endophthalmitis following cataract surgery in Sweden. The 1998 national prospective survey. Acta Ophthalmol Scand. 2002;80:258–261
  15. West ES, Behrens A, McDonnell PJ, Tielsch JM, Schein OD. The incidence of endophthalmitis after cataract surgery among the U.S. Medicare population increased between 1994 and 2001. Ophthalmology. 2005;112:1388–1394
  16. Taban M, Behrens A, Newcomb RL, Nobe MY, Saedi G, Sweet PM, et al. Acute endophthalmitis following cataract surgery; a systematic review of the literature. Arch Ophthalmol. 2005;123:613–620
  17. ESCRS Endophthalmitis Study Group. Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg. 2007;33:978–988
  18. Lalitha P, Rajagopalan J, Prakash K, Ramasamy K, Prajna NV, Srinivasan M. Postcataract endophthalmitis in South India; incidence and outcome. Ophthalmology. 2005;112:1884–1890
  19. Boks T, van Dissel JT, Teterissa N, Ros F, Mahmut MH, Utama ED, et al. An outbreak of endophthalmitis after extracapsular cataract surgery probably caused by endotoxin contaminated distilled water used to dissolve acetylcholine. Br J Ophthalmol. 2006;90:1094–1097
  20. Dick HB, Augustin AJ, Pakula T, Pfeiffer N. Endotoxins in ophthalmic viscosurgical devices. Eur J Ophthalmol. 2003;13:176–184
  21. PatnaikB Biswas C, Patnaik RK. Sterile endophthalmitis in vitrectomised eyes due to suspected heat resistant endotoxins in the infusion fluid. Indian J Ophthalmol. 2004;52:127–131Available at: http://www.ijo.in/temp/IndianJOphthalmol522127-4747157_131111.pdfAccessed January 15, 2009
  22. Kalpadakis P, Tsinopoulos I, Rudolph G, Schebitz K, Froehlich SJ. A comparison of endophthalmitis after phacoemulsification or extracapsular cataract extraction in a socio-economically deprived environment: a retrospective analysis of 2446 patients. Eur J Ophthalmol. 2002;12:395–400
  23. Moshirfar M, Feiz V, Vitale AT, Wegelin JA, Basavanthappa S, Wolsey DH. Endophthalmitis after uncomplicated cataract surgery with the use of fourth-generation fluoroquinolones; a retrospective observational case series. Ophthalmology. 2007;114:686–691
  24. Lundström M, Wejde G, Stenevi U, Thorburn W, Montan P. Endophthalmitis after cataract surgery; a nationwide prospective study evaluating incidence in relation to incision type and location. Ophthalmology. 2007;114:866–870
  25. Fang Y-T, Chien L-N, Ng Y-Y, Chu H-F, Chen W-M, Cheng C-Y, et al. Association of hospital and surgeon operation volume with the incidence of postoperative endophthalmitis; Taiwan experience. Eye. 2006;20:900–907
  26. Ng JQ, Morlet N, Bulsara MK, Semmens JB. Reducing the risk for endophthalmitis after cataract surgery: population-based nested case-control study; Endophthalmitis Population Study of Western Australia sixth report. J Cataract Refract Surg. 2007;33:269–280
  27. Garcia-Arumi J, Fonollosa A, Sararols L, Fina F, Martínez-Castillo V, Boixadera A, et al. Topical anesthesia: possible risk factor for endophthalmitis after cataract extraction. J Cataract Refract Surg. 2007;33:989–992
  28. Rummelt V, Boltze HJ, Jünemann A, Röllinghoff M, Naumann GOH. Zur Persistenz und Transienz der konjunktivalen Keimbesiedelung vor geplanten intraokularen Eingriffen. [Persistent and transient microbial colonization of the conjunctiva before planned intraocular surgery]. Klin Monatsbl Augenheilkd. 1992;20:231–233
  29. Nirmalan PK, Lalitha P, Prajna VN. Can antiseptic scrubs between cataract surgeries reduce bacterial load on surgical gloves to safe levels?. [letter] Br J Ophthalmol. 2004;88:438–439

 No author has a financial or proprietary interest in any material or method mentioned.

 M. Selvarani, Priya Paulraj, G. Rekha, P.R. Nagalakshmi, Aravind Eye Hospital, Pondicherry, collected data. Nithya Neelakantan, Biostatistician, Aravind Eye Care System, Madurai, helped analyze the data.

PII: S0886-3350(09)00067-4

doi: 10.1016/j.jcrs.2009.01.002

Journal of Cataract & Refractive Surgery
Volume 35, Issue 4 , Pages 629-636 , April 2009

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