Acute Endophthalmitis After Cataract Surgery: 250 Consecutive Cases Treated at a Tertiary Referral Center in the Netherlands

Pijl, Benjamin J.; Theelen, Thomas; Tilanus, Maurits A. D.; Rentenaar, Rob J.; Crama, Niels

doi:10.1016/j.ajo.2009.09.021

Cited by 111 publications

(98 citation statements)

References 20 publications

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“…The conjunctival bacteria isolated in each of the patients were prospectively recorded in the laboratory database, which also contains the medical record numbers and demographic data of the patients, and the origin and collecting date of the samples among other data. Bacteria were grouped as in order to obtain a number of samples as big as possible for carrying out statistical comparisons, and paying attention to their above described pathogenic power in PE cases [17][18][19][20][21][22][23][24][25] (S. aureus, Streptococcus species, Enterococci, Bacillus spp, and most Gram-negative rods).…”

Section: Methodsmentioning

confidence: 99%

“…The devastating effect of these bacteria was also shown after the EVS in several studies. 4,[20][21][22][23][24][25] Taking into account the role of the conjunctival flora as the main source of bacterial contamination during the intraocular surgery, 26 what is remarkable is the low prevalence of these pathogenic bacteria on the conjunctiva of patients operated on for cataract in all the published studies. [27][28][29][30] However, very little is known about whether the clinical characteristics of this small number of patients with pathogenic bacteria colonising their conjunctivas are different.…”

Section: Introductionmentioning

confidence: 99%

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Pathogenic conjunctival bacteria associated with systemic co-morbidities of patients undergoing cataract surgery

Cuesta-Rodríguez

et al. 2013

Eye

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Purpose To identify the risk of patients undergoing cataract surgery of having pathogenic conjunctival bacteria associated with their systemic co-morbidities. Methods Retrospective study of consecutive patients undergoing their first cataract operation from July 2005 to April 2010. Their preoperative conjunctival bacteria were cultured, identified, and classified in bacterial groups. Their co-morbidities were defined from their clinical data and the answers to systematic questions asked in the anaesthetic evaluation. The Microsoft Access databases of the two data sets were merged for carrying out the statistical analysis. Univariate association of each bacterial group with each co-morbidity was studied by using w 2 -test for categorical data and Student's t-test for continuous variables. Also, logistic regression models were used adjusting for age and sex. SPSS statistic programme, version 18 was used for all these analyses. Endophthalmitis cases in this surgical series were searched. Results In the 8333 selected patients, age was associated with increased conjunctival bacteria in all groups except for Streptococcus pneumoniae and Propionibacteriae. However, male sex was associated with these two groups and also with coagulase-negative Staphylococci, Corynebacterium xerosis, Staphylococcus aureus, and Gram-negative rods. After adjusting for age and sex, S. aureus was associated with diabetes, lung diseases, and renal and heart insufficiency; Gram-negative rods with smoking habit; Enterococci with diabetes; Streptococcus pneumoniae with kyphoscoliosis; and other Streptococci with diabetes and handicapped patients. Conclusion The more pathogenic conjunctival bacteria were more likely associated with patients' co-morbidities, such as diabetes, lung diseases, renal and heart insufficiency, kyphoscoliosis, and smoking habit, than the less pathogenic ones.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pathogenic conjunctival bacteria associated with systemic co-morbidities of patients undergoing cataract surgery

Cuesta-Rodríguez

et al. 2013

Eye

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“…2 The reported yield of CM in endophthalmitis varies between 26 and 66%. 5,6,[8][9][10][11] Lower yields have been related to suboptimal access to laboratory facilities, 6 and to infections due to other than postoperative endophthalmitis. 10 Our yield in CM was 72%, falling in the favorable end of the spectrum.…”

Section: Discussionmentioning

confidence: 99%

The additional value of blood culture bottles in the diagnosis of endophthalmitis

Tan

Ghyczy-Carlborg

Spanjaard

et al. 2011

Eye

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Purpose To assess the additional value of blood culture bottles (BCBs) in the diagnosis of endophthalmitis by comparing its culture yield with that of conventional media (CM). Design Retrospective consecutive case series. Methods We included patients who were treated between January 2001 and January 2010 for clinically suspected endophthalmitis of any etiology, and had vitreous specimens cultivated in both BCB and CM. Results Specimens from 85 eyes from 85 patients were included. The culture yield of BCB was 69%, and that of CM was 72% (difference not significant). Adding the results of BCB improved the yield of CM significantly by 13%, resulting in a combined yield of 81%. The sensitivity of detection of Haemophilus influenzae in BCB seemed lower compared with CM, possibly due to the lack of growth factors in the BCB. There was no difference in yield between specimens obtained by tap or by vitrectomy. Conclusion In contrast with earlier reports, we did not find BCB superior to CM. The combined use of BCB and CM increased the pathogen detection rate significantly and should therefore be considered as the microbiological method of choice in the work-up of endophthalmitis.

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“…Once it occurs, endophthalmitis can profoundly affect visual function and ocular tissues. Timely and effective therapy is extremely important to clinical prognosis and surgical treatment outcomes (Pijl et al, 2010). Here, we report the outcomes of using vitrectomy in combination with intravitreal injection to treat endophthalmitis occurring after phacoemulsification and IOL implantation.…”

Section: Introductionmentioning

confidence: 99%

Clinical features and treatment of endophthalmitis after cataract surgery

Zhu

2015

Genet. Mol. Res.

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ABSTRACT. The aim of this study was to investigate the clinical features and treatment results of endophthalmitis after cataract surgery. Five patients with endophthalmitis after phacoemulsification with intraocular lens implantation were enrolled in this study. The pathogenesis, clinical manifestation, and surgical outcomes of 5 patients were compared. Three patients were surgically treated with anterior chamber irrigation and vitrectomy with intravitreal injection. The remaining two patients were medically treated with an intravitreal injection of vancomycin and ceftazidime. Treatment results of the five patients were analyzed. Four patients had positive cultures for bacteria (two cases Staphylococcus epidermidis, one case Enterococcus faecalis, and one case head-like Staphylococcus). The culture of the fifth patient did not have bacterial growth. One year following treatment, four patients had restored visual acuity and a clear vitreous cavity. Retinal detachment and other complications were not observed. The remaining patient had a visual acuity of index at 30 cm one year following treatment. For patients with endophthalmitis after cataract surgery, a biochemical laboratory examination should be promptly performed and should include a bacterial culture and drug sensitivity test. When necessary, vitrectomy combined with an intravitreal injection of vancomycin should be performed to treat the infection early and to help retain useful vision.

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Acute Endophthalmitis After Cataract Surgery: 250 Consecutive Cases Treated at a Tertiary Referral Center in the Netherlands

Cited by 111 publications

References 20 publications

Pathogenic conjunctival bacteria associated with systemic co-morbidities of patients undergoing cataract surgery

Pathogenic conjunctival bacteria associated with systemic co-morbidities of patients undergoing cataract surgery

The additional value of blood culture bottles in the diagnosis of endophthalmitis

Clinical features and treatment of endophthalmitis after cataract surgery

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