Incidence, management, and visual outcomes in pediatric endophthalmitis following cataract surgery by a single
Sumita Agarkar1, Roshani Desai1, Malathi Jambulingam2
1Pediatric Ophthalmology Department, Sankara Nethralaya, Chennai, India.
Insights
Pediatric cataract surgery rarely leads to endophthalmitis (0.376%), which typically presents rapidly with pain and redness. Early intervention is key for vision salvage.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Infectious Diseases
Background:
- Cataract surgery in children presents unique challenges.
- Postoperative endophthalmitis is a serious complication following ocular procedures.
Purpose of the Study:
- To determine the incidence of endophthalmitis after pediatric cataract surgery.
- To characterize the microbiological profile, management, and visual outcomes of endophthalmitis.
Main Methods:
- Retrospective review of pediatric cataract surgeries performed by a single surgeon (2000-2012).
- Identification and analysis of endophthalmitis cases, including time to diagnosis, symptoms, and treatment.
Main Results:
- Overall endophthalmitis rate was 0.376% in 2,390 surgeries.
- Median time to diagnosis was 2.5 days; common symptoms were pain and redness.
- Acinetobacter calcoaceticus was a predominant organism; many were resistant to ceftazidime.
- Early vitrectomy led to good visual recovery in 4 out of 5 cases.
Conclusions:
- Endophthalmitis after pediatric cataract surgery is rare but can cause rapid vision loss.
- Prompt diagnosis and treatment, including vitrectomy, are crucial for visual outcomes.
Purpose:
To report the incidence of endophthalmitis following cataract surgery by a single surgeon in children and to describe its microbiological profile, management, and visual outcomes.
Methods:
The medical records of patients who underwent cataract surgery performed by a single surgeon between January 2000 and December 2012 were retrospectively reviewed to identify those with postoperative endophthalmitis. The primary goals of the study were to describe the incidence of endophthalmitis, microbiological profile, and measure visual acuity after management.
Results:
A total of 2,390 cataract surgeries were performed during the study period. The overall endophthalmitis rate during the study period was 0.376% (95% CI, 0.357-0.395). Of the 9 cases of postoperative endophthalmitis identified, 8 had a median duration of 2.5 days between time of surgery and diagnosis. The common presenting symptoms were pain and redness. Of the 5 cases in which early vitrectomy was performed, 4 showed good visual recovery at final follow-up visit. Both Gram-positive and Gram-negative organisms were seen equally. Culture-positive results were seen in 4 patients, the majority of which showed Acinetobacter calcoaceticus. Most of the organisms were resistant to ceftazidime.
Conclusions:
Endophthalmitis following pediatric cataract surgery is rare but occurs rapidly and can cause severe loss of vision. Early recognition and treatment can help in salvaging the vision.
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