Abstract
Aims To estimate the incidence of acute-onset presumed infectious endophthalmitis (PIE) following cataract surgery in the UK and provide epidemiological data on the presentation, management, microbiology, and outcome of cases of endophthalmitis.
Methods Cases were identified prospectively by active surveillance through the British Ophthalmological Surveillance Unit reporting card system, for the 12-month period October 1999 to September 2000 inclusive. Questionnaire data were obtained from ophthalmologists throughout the UK at baseline and 6 months after diagnosis. Under-reporting was estimated by independently contacting units with infection databases.
Results Data were available on 213 patients at baseline and 201 patients at follow-up. The minimum estimated incidence of PIE was 0.086 per 100 cataract extractions and the corrected incidence was 0.14 per 100 cataract extractions. For the management of PIE, 96% of patients received intravitreal, 30% subconjunctival, 65% oral, and 17% intravenous antibiotics. In all, 17% of patients received intravitreal steroid. From the intraocular samples taken for microbiological analysis, 56% were culture positive. At follow-up, 48% of patients achieved visual acuity of 6/12 or better and 66% achieved better than 6/60. 13% of patients were unable to perceive light or had evisceration of the globe.
Conclusions The incidence of PIE after cataract surgery in the UK is comparable to that of other studies. Approximately 50% of patients achieved a visual acuity close to the driving standard.
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Acknowledgements
We are very grateful for the support of the British Ophthalmological Surveillance Unit.
We thank Mr MD Cole, Torbay Hospital and Professor S Lightman, Institute of Ophthalmology, London for providing helpful advice.
This work was supported by the British Medical Association Middlemore and John William Clarke awards, for which we are grateful.
We particularly thank the following Ophthalmologists for helping with the data collection for our study: Mr SP Aggarwal, Mr BDS Allan, Mr ED Allen, Mr N Anand, Mr S Armstrong, Mr MW Austin, Mr PJ Bacon, Dr T Barrie, Mr R Bates, Mr AK Bates, Mr JDL Beare, Mr MA Bearn, Mrs L Beck, Mr B Beigi, Dr GJB Bedford, Dr RWD Bell, Mr PD Black, Mr RC Bosanquet, Mr DC Broadway, Mr RL Burton, Miss ZA Butt, Mr AB Callear, Mr SH Campbell, Mr C Canning, Mr AG Casswell, Miss M Chatterjee, Mr SK Choudhuri, Mr M Clowes, Mr SD Cook, Miss M Corbett, Mr PG Corridan, Mr EA Craig, Mr JKG Dart, Mr RB Dapling, Mr D David, Mr C Dees, Mr SP Desai, Mr J Deutsch, Mr D Dhingra, Mr CJM Diaper, Professor A Dick, Mr RS Edwards, Mr M Ekstein, Mr IR Fearnley, Dr AI Fern, Mr TJ Fetherston, Miss L Ficker, Mr FF Fisher, Mr Fouladi, Miss W Franks, Mr LB Freeman, Mr TJ Freegard, Dr MP Gavin, Mr PTS Gregory, Mr BP Greaves, Mr AK Gupta, Mr M Harris, Mr AA Hashim, Mr S Hardman Lea, Mr W Hoe, Mr IH Hubbard, Mr RC Humphry, Mr DS Hughes, Mr JR Innes, Mr DV Inglesby, Mr B James, Mr JSH Jacob, Mr D Jones, Mr PW Joyce, Mr J Keast-Butler, Mr MG Kerr-Muir, Mr T Leslie, Mr SG Levy, Mr J Lipton, Mr CSC Liu, Mr D Lloyd-Jones, Miss AL Lyness, Mr TD Manners, Dr CJ MacEwen, Professor D Mcleod, Mr JN McGalliard, Mr JMS McConnell, Dr Moosavi, Mr AT Moore, Mr SJ Morgan, Mrs CE Morton, Mr A Murray, Professor PI Murray, Dr SB Murray, Dr RI Murray, Mr ME Nelson, Mr BJ McNeela, Mr NP O’Donnell, Mr G O’Connor, Mr CO Peckar, Mr RV Pearson, Mr RP Phillips, Mr P Phelan, Mr W Pollock, Mr K Potu, Mr S Rassam, Professor IG Rennie, Mr RM Redmond, Mr T Rimmer, Mr PH Rosen, Mr J Shah, Mr D Steele, Dr IG Syme, Mr C Stevenson, Mr RJ Stirling, Mr P Sullivan, Miss HC Seward, Mr JH Sandford-Smith, Mr KP Stannard, Mr G Sturrock, Mr T Shetti, Miss SN Stefanous, Mr SJ Talks, Mr V Thaller, Mr GM Thompson, Mr NMG Toma, Mr S Tuft, Mr AB Tullo, Mr AG Tyers, Mr S Verghese, Mr AJ Vivian, Miss A Walker, Mr J Wallace, Mr RF Walters, Mr JNF West, Ms S Weber, Dr IF White, Mr ACA While, Mr WH Woon, Mr R Wormald.
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Kamalarajah, S., Silvestri, G., Sharma, N. et al. Surveillance of endophthalmitis following cataract surgery in the UK. Eye 18, 580–587 (2004). https://doi.org/10.1038/sj.eye.6700645
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DOI: https://doi.org/10.1038/sj.eye.6700645
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