Incidence and visual outcome of acute endophthalmitis after cataract surgery--the experience of an eye department in Scotland.

Abstract

Endophthalmitis remains one of the most dreaded complications of modern cataract surgery. Its incidence in the UK has been estimated but accurate published data on the incidence at a regional level are scarce. This audit examines the incidence and visual outcome of endophthalmitis from a single eye department in Scotland (UK) over a 7-year period. Findings are compared with those from other series. A retrospective consecutive audit of all cases of acute endophthalmitis treated between 1 January 2000 and 31 December 2006 at the Southern General Hospital in Glasgow (Scotland, UK) was undertaken. Details of each case (presentation, treatment and outcome of endophthalmitis) were recorded. Cross-tabulations were performed to identify prognostic factors of visual outcome. Twenty-five patients were treated for endophthalmitis over the audit period. The incidence of endophthalmitis was 0.20% (95% CI 0.10 to 0.30%). There were 12 (48%) culture-positive cases with coagulase-negative staphylococcus accounting for 58%. After treatment, 16 patients (64%) achieved driving-standard vision or better. Poor vision at presentation and streptococcal endophthalmitis were associated with poor visual outcome. The incidence of endophthalmitis in this series is comparable to larger studies, suggesting that accepted benchmarks, despite being estimates, reflect UK practice. Visual outcome, with treatment, can be favourable in a significant proportion of patients.