Postoperative endophthalmitis: A ten-year series

PurposeTo assess the incidence and outcomes of postoperative endophthalmitis (POE) at the Royal Victoria Eye and Ear Hospital (RVEEH), Dublin, Ireland over a ten year period.MethodsPatients who underwent vitreous and/or aqueous sampling and received antibiotics and/or antifungals for suspected POE at RVEEH between July 2012 and July 2022 were included. Cases were classified as microbiologically-confirmed infection, presumed infection, or likely inflammatory. Demographic, clinical, microbiological, and visual outcome data were analysed. Incidence rates were calculated for post-intravitreal injection (IVI) procedures and post-phacoemulsification surgeries.ResultsA total of 149 episodes of suspected POE occurred in 147 patients: 70 (47%) confirmed, 66 (44.3%) presumed, and 13 (8.7%) likely inflammatory. The commonest inciting procedures included IVI (n = 60) and phacoemulsification cataract surgery (n = 59). Final visual acuity (VA) ≥ 6/12 was achieved in 49% of post-phacoemulsification cases and 20% of post-IVI cases. Independent predictors of poor visual outcome included confirmed infectious POE (OR 5.5, 95% CI 1.7-17.6) and worse presenting VA (OR 1.4 per 0.2 logMAR, 95% CI 1.1-1.8). The incidence of POE was 0.04% post-IVI and 0.1% post-phacoemulsification surgery.ConclusionsThis is the largest analysis of POE in Ireland and may serve as a useful national benchmark. Despite the sustained rise in IVI use, phacoemulsification and IVIs contributed a comparable number of POE cases, with post-phacoemulsification cases achieving better visual outcomes.