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Intravitreal Injection and Quantitation of Infection Parameters in a Mouse Model of Bacterial Endophthalmitis

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Endophthalmitis Rates and Types of Treatments After Intraocular Procedures.

Brian L VanderBeek^1,2,3, Yineng Chen³, Maurizio Tomaiuolo⁴

¹Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.

JAMA Ophthalmology

|August 1, 2024

Summary

Endophthalmitis rates after intraocular procedures have significantly decreased over 20 years. Concurrently, the use of prompt vitrectomy as a primary treatment for endophthalmitis has also declined.

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Area of Science:

Ophthalmology
Infectious Disease Epidemiology

Background:

Endophthalmitis remains a serious complication following intraocular procedures.
Long-term trends in endophthalmitis rates and treatment strategies are not well-documented.
The impact of deviating from Endophthalmitis Vitrectomy Study recommendations on outcomes is unclear.

Purpose of the Study:

To analyze trends in endophthalmitis incidence after intraocular procedures over two decades.
To investigate changes in the primary treatment approach for endophthalmitis, specifically the utilization of prompt vitrectomy versus tap and inject.

Main Methods:

A large cohort study utilizing a US administrative medical claims database from 2000 to 2022.
Inclusion of various intraocular procedures such as cataract surgery, glaucoma procedures, retinal surgeries, and corneal transplants.
Exclusion of patients with prior endophthalmitis or concurrent procedures to ensure data integrity.

Main Results:

Over 5.8 million intraocular procedures were analyzed, with an overall endophthalmitis rate of 0.07%.
A significant yearly decline in endophthalmitis incidence was observed (2.7% decrease per year).
The utilization of prompt vitrectomy as primary treatment also decreased significantly (3.8% per year).

Conclusions:

The incidence of endophthalmitis following intraocular procedures has substantially decreased over the past 20 years.
There has been a concurrent decline in the use of prompt vitrectomy for endophthalmitis treatment.
Further research is needed to understand the long-term implications of these trends on patient vision outcomes.