Comparative Endophthalmitis Rates in Adult and Pediatric Patients across Various Ophthalmic Procedures: An IRIS® Registry Analysis
Related Experiment Video
Updated: Jul 4, 2026
Intravitreal Injection and Quantitation of Infection Parameters in a Mouse Model of Bacterial Endophthalmitis
Published on: February 6, 2021
Celine Chaaya1, Eric A Goldberg1, Connor J Ross1
1Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
Purpose:
To evaluate the incidence of endophthalmitis after ophthalmic surgery using a national ophthalmic registry.
Design:
Retrospective clinical cohort study.
Participants:
Patients in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) who underwent ophthalmic surgeries were included in this analysis.
Main Outcome Measure:
Incidence of endophthalmitis during the first 30 days after surgery.
Methods:
Pediatric and adult patients in the IRIS® Registry with a diagnosis of acute endophthalmitis within 30 days after surgery from 2016 through 2024.
Results:
The study analyzed 17 457 881 procedures. Rates of endophthalmitis varied by procedure. Among adults, the highest incidence occurred after open-globe repair (0.94%; 1 case per 106 procedures). The incidence of endophthalmitis was 0.097% (1 case per 1031 procedures) after vitrectomy for retinal detachment, 0.1% for trabeculectomy (1 case per 1000 procedures), 0.075% for tube shunts (1 case per 1333 procedures), and 0.068% for scleral buckle surgery (1 case per 1459 procedures). The incidence after cataract surgery was 0.038% (1 case per 2652 procedures), 0.039% (1 case per 2551 procedures) after standalone minimally invasive glaucoma surgery, 0.02% (1 case per 5013 procedures) after goniotomy, and 0.011% for strabismus surgery (1 case per 9091 procedures). Among pediatric patients, the incidence of endophthalmitis after open-globe repair was 0.87% (1 case per 115 procedures). The incidence of endophthalmitis was 0.415% (1 case per 675 procedures) after scleral buckle surgery, 0.11% (1 case per 871 procedures) after cataract surgery, 0.084% (1 case per 1190 procedures) after vitrectomy for retinal detachment, and 0.0072% (1 case per 13 884 procedures) after strabismus surgery. The risk of endophthalmitis was significantly higher for pediatric vs. adult patients after cataract surgery (P = 0.014). Endophthalmitis rates after same-date cataract and glaucoma surgery vs. glaucoma surgery alone did not differ significantly.
Conclusions:
Rates of endophthalmitis after ophthalmic surgical procedures are variable, with the highest incidence being open-globe repair. Minimally invasive glaucoma surgery procedures showed comparable infection rates as standard cataract surgery. A higher rate of infection after cataract surgery occurred in pediatric patients when compared with adults.
Financial Disclosure(S):
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
