Incidence of Endophthalmitis after Corneal Transplant or Cataract Surgery in a Medicare Population

Is combined cataract surgery associated with acute postoperative endophthalmitis? A nationwide study from 2005 to 2014

“…For corneal surgery, a recent paper investigated the incidence of acute POE after corneal transplant, cataract surgery and combined surgery in a large Medicare population 17. According to the authors, this study was the first to report on endophthalmitis after concurrent corneal transplant and cataract surgery; a higher acute POE incidence was found in the corneal transplant group and the combined surgery group versus cataract surgery performed as a single procedure (0.420%, 0.351% vs 0.127%, respectively, p<0.0001) 17.…”

Report of the Eye Bank Association of America Medical Review Subcommittee on Adverse Reactions Reported From 2007 to 2014

“…The reported incidence of endophthalmitis, which has been generally derived from individual institutions, international registry data, and Medicare databases, ranges from 0.142% to 0.67%. [5][6][7][8][9][10] EBAA data published by Hassan et al 8 reported 162 cases of endophthalmitis after PK from 1994 to 2003. The incidence was 0.047% (n = 162) of 340,174 grafts performed in the United States.…”

“…7,9,20 The incidence of fungal infection including keratitis and endophthalmitis after PK was reported to be 0.16% (n = 4) of 2466 grafts, from the New York Eye and Ear Infirmary. 20 Our study similarly shows low combined fungal infection incidence after keratoplasty at 0.023% (n = 83) of 354,930 grafts.…”

“…[5][6][7][8][9][10] There was relative paucity of data reporting: (1) the incidence relative to the procedure type, comparing penetrating keratoplasty (PK), endothelial keratoplasty (EK), anterior lamellar keratoplasty (ALK), and keratoprosthesis (KPro); (2) the incidence of "other" adverse reactions, including infectious keratitis, inadvertent use of postrefractive surgery tissue, transmission of corneal dystrophy, and systemic infection; (3) the changing milieu of infectious pathogens associated with EK compared with PK.…”

Scanning Electron Microscopic Analysis of Biofilm Formation in Explanted Human Boston Type I Keratoprostheses

“…14 Although up to 46% of aqueous samples taken at the end of routine cataract surgery are culture positive for bacteria, 15 the rate of post-cataract surgery endophthalmitis remains exceedingly low at 0.03%-0.20%. [16][17][18] However, unlike free-floating bacteria in the anterior chamber, bacteria within biofilms may be dormant and exist in sequestered environment that only intermittently releases bacteria. 19 This may explain the lack of positive cultures or clinical signs of infection in eyes with …”