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Comparative Endophthalmitis Rates in Adult and Pediatric Patients across Various Ophthalmic Procedures: An IRIS®
Celine Chaaya1, Eric A Goldberg1, Connor J Ross1
1Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
Ophthalmology
|April 15, 2026
Summary
Endophthalmitis rates after eye surgery vary significantly by procedure, with open globe repair having the highest incidence. Pediatric patients face a higher risk of infection after cataract surgery compared to adults.
Area of Science:
- Ophthalmology
- Infectious Disease Epidemiology
Background:
- Endophthalmitis is a serious intraocular infection following ophthalmic surgery.
- Understanding the incidence of endophthalmitis is crucial for patient safety and surgical practice improvement.
Purpose of the Study:
- To evaluate the incidence of endophthalmitis after various ophthalmic surgical procedures.
- To compare endophthalmitis rates between adult and pediatric patients.
Main Methods:
- Retrospective cohort study utilizing the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight).
- Analysis included over 17 million ophthalmic procedures performed between 2016 and 2024.
- Incidence of endophthalmitis within 30 days post-surgery was the primary outcome measure.
Main Results:
- Open globe repair demonstrated the highest endophthalmitis incidence (0.94% in adults, 0.87% in pediatric patients).
- Minimally invasive glaucoma surgery (MIGS) procedures showed infection rates comparable to standard cataract surgery (0.039% vs. 0.038%).
- Pediatric patients had a significantly higher risk of endophthalmitis after cataract surgery than adults (0.11% vs. 0.038%, P = 0.014).
Conclusions:
- Endophthalmitis incidence varies widely across ophthalmic surgical procedures.
- Open globe repair carries the highest risk, while MIGS procedures are associated with low infection rates similar to cataract surgery.
- Pediatric patients require specific attention due to increased risk following cataract surgery.
