Incidence, management, and visual outcomes in pediatric endophthalmitis following cataract surgery by a single surgeon

Agarkar, Sumita; Desai, Roshani; Malathi, Jambulingam; Sumeer, Singh H.; Raman, Rajiv

doi:10.1016/j.jaapos.2016.05.010

Cited by 14 publications

(12 citation statements)

References 9 publications

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“…All studies were completed on adult subjects except for one which was completed on pediatric patients with congenital or developmental cataracts. 11 The average number of days between the causative operation and first presentation of endophthalmitis was within 2 weeks for all included studies, where this information was reported. There was large heterogeneity in the follow-up practices after initial treatment with the median follow-up period ranging from 2.1 months to 60 months in another study.…”

Section: Patient Presentation and Follow-up Practicesmentioning

confidence: 99%

Tap and Inject Versus Pars Plana Vitrectomy for Postprocedural Endophthalmitis

Far

Yeung

Farimani

et al. 2021

Retina

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Purpose: To compare the visual outcomes after prompt pars plana vitrectomy (PPV) with tap biopsy and intravitreal antimicrobial injection to treat postinjection and postsurgery endophthalmitis.Methods: The Cochrane Central Register of Controlled Trials, Ovid MEDLINE, and Ovid Embase databases were searched for articles published between January 2010 and November 2020. Two independent reviewers selected articles and extracted data. We analyzed data in RevMan 5.3 and assessed methodological quality using the Cochrane ROBINS-I tool. The mean improvement in visual outcome was compared between PPV and intravitreal antimicrobial injection as a relative risk of improving $2 lines and a mean logarithm of the minimal angle of resolution difference in improvement.Results: Fifteen retrospective case series (1,355 eyes), of which 739 eyes (55%) received intravitreal antimicrobial injection and 616 (45%) received PPV as initial treatment, were included. The overall relative risk of improving 2 or more lines in PPV in comparison with intravitreal antimicrobial injection was 1.04 (95% CI 0.88-1.23; P = 0.61; I 2 = 0%) with a mean difference of 0.04 (95% CI 20.18 to 0.27; P = 0.69; I 2 = 0%). The results stayed robust when subgroup analysis based on causative procedure for endophthalmitis was performed.Conclusion: Intravitreal antimicrobial injection is noninferior to PPV for the treatment of postcataract operation, postinjection, and post-PPV endophthalmitis.

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Section: Patient Presentation and Follow-up Practicesmentioning

confidence: 99%

Tap and Inject Versus Pars Plana Vitrectomy for Postprocedural Endophthalmitis

Far

Yeung

Farimani

et al. 2021

Retina

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“…Pediatric endophthalmitis is a rare but devastating condition, resulting in visual impairment and even blindness. The reported incidence of pediatric endophthalmitis following cataract surgery ranges from 0.38 to 0.45% [1,2]. The incidence is estimated at 2.8-54.2% in the pediatric age group with ocular trauma, which varies by country [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Etiology, microbiological isolates, and antibiotic susceptibilities in culture-proven pediatric endophthalmitis: a 9-year review

Yang

Lin

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Purpose To analyze the etiology, microbiological isolates, and antibiotic susceptibilities of endophthalmitis in pediatric patients. Methods Patients aged < 18 years with culture-positive endophthalmitis in Zhongshan Ophthalmic Center between January 2010 and December 2018 were included retrospectively. Results A total of 127 patients (127 eyes) were included, and 108 (85%) had posttraumatic endophthalmitis. Streptococcus (21.4%), coagulase-negative Staphylococcus (14.5%), Aspergillus (6.9%), and Bacillus cereus (5.3%) were the common organisms. The proportion of Streptococcus decreased with age (40.0% in 0-3 years, 16.3% in 4-12 years, and 6.3% in 13-17 years), while coagulase-negative Staphylococcus increased from 5.7% to 18.8%. Overall, fluoroquinolones achieved the highest antibiotic susceptibility rate (> 95%), while the susceptibility of isolated bacteria to tobramycin and cefazolin was only 60.2% and 59.4%, respectively. The susceptibility rates of Gram-positive cocci to cephalosporins were nearly 90%. For Gram-negative bacilli, susceptibility to neomycin was 91.3%. Conclusion Trauma was the main etiology for pediatric endophthalmitis. Although Streptococcus was the most prevalent organism in general, the dominant pathogen varied with age, which merits clinical attention. Fluoroquinolones showed the highest antibiotic efficacy; however, commonly used antibiotics tobramycin and cefazolin showed relatively low antibiotic susceptibility. Thus, antibiotic resistance in pediatric populations merits clinical attention.

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“…Keratitis is one of the most serious eye infections and may progress to endophthalmitis [41]. Pediatric endophthalmitis is a rare but devastating condition, and the rate of endophthalmitis after cataract surgery ranges from 0.1 to 0.45% [42,43], while the rate after eye trauma ranges from 2.8 to 71.8%, with a relatively high incidence in developing countries [44]. Knowledge of the specific etiology is critical for the effective management of eye infections.…”

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confidence: 99%

Spectrum of ophthalmic diseases in children hospitalized in a tertiary ophthalmology hospital in China from 2010 to 2019

Xia

Rao

et al. 2022

BMC Ophthalmol

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Background Describing the pattern of pediatric eye diseases is necessary for appropriate eye care in children. This study explored the spectrum and characteristics of pediatric ophthalmic diseases in a typical tertiary ophthalmology hospital in China. Methods A retrospective study was conducted at a tertiary ophthalmology hospital between 2010 and 2019 in Guangzhou, China. This study included 44,552 inpatients who were younger than 18 years old. Demographic and diagnostic data were collected from the electronic medical record system. Multiphase regression analysis was used to estimate trends in the annual percentages of ten common ophthalmic diseases. Results From 2010 to 2019, 44,552 inpatients met the inclusion criteria. The majority were male (61.9%), aged 7 to 12 years (30.3%) and self-paying (56.6%). The top ten conditions were refractive error (41.2%), strabismus (36.1%), cataract (13.6%), trauma (11.8%), congenital ptosis (8.8%), tumor (8.1%), amblyopia (7.1%), glaucoma (7.0%), entropion and trichiasis of eyelid (7.0%), and retinal detachment (6.5%). The annual percentage changes (APCs) for refractive error, strabismus, and retinal detachment were 9.3% (95% CI, 8.1–10.5%), 4.7% (95% CI, 3.8–5.6%) and − 2.8% (95% CI, − 5.1% to − 0.4%) respectively. For trauma, the average APC (AAPC = -9.2%, (95% CI, − 12.1% to − 6.2%) decreased gradually from 2010 to 2015 (APC = -4.2% (95% CI, − 8.8-0.7%)) and decreased rapidly from 2015 to 2019 (APC = -15.1% (95% CI, − 21.0% to − 8.7%)). Conclusions Pediatric ophthalmic diseases are common in China. Preventive strategies and health education aimed at the prevention of refractive error, strabismus, and entropion and trichiasis of eyelid will be crucial in reducing the burden of pediatric ophthalmic diseases on health care systems and human development.

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Incidence, management, and visual outcomes in pediatric endophthalmitis following cataract surgery by a single surgeon

Cited by 14 publications

References 9 publications

Tap and Inject Versus Pars Plana Vitrectomy for Postprocedural Endophthalmitis

Tap and Inject Versus Pars Plana Vitrectomy for Postprocedural Endophthalmitis

Etiology, microbiological isolates, and antibiotic susceptibilities in culture-proven pediatric endophthalmitis: a 9-year review

Spectrum of ophthalmic diseases in children hospitalized in a tertiary ophthalmology hospital in China from 2010 to 2019

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