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Kyung, Kwang, and Yu: Factors Affecting Final Visual Acuity in Infectious Endophthalmitis Following Cataract Surgery
Original Article

J Korean Ophthalmol Soc 2013;54(7):1025-1031.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.7.1025

Factors Affecting Final Visual Acuity in Infectious Endophthalmitis Following Cataract Surgery

Tae Kang Kyung, MD, Soo Kim Kwang, MD, PhD, Cheol Kim Yu, MD

1Department of Ophthalmology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea

Address reprint requests to Yu Cheol Kim, MD Department of Ophthalmology, Keimyung University Dongsan Medical Center, #56 Dalseong-ro, Jung-gu, Daegu 700-712, Korea Tel: 82-53-250-8026, Fax: 82-53-250-7705 E-mail: eyedr@dsmc.or.kr

* This study was presented as a poster at the 108th Annual Meeting of the Korean Ophthalmology Society 2012.

Received 8 December 201221 February 2013       Accepted 8 May 2013

Copyright © 2013 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the factors affecting the clinical outcome and final visual acuity in patients with infectious endoph-thalmitis following cataract surgery.

Methods

In this study, 35 patients who were diagnosed with endophthalmitis following cataract surgery from 2003 to 2012 were retrospectively analyzed. To evaluate factors affecting final visual acuity, the following were investigated: initial visual acuity, presence of diabetes mellitus, onset of endophthalmitis after the cataract surgery, performance of vitrectomy, dura-tion between diagnosis and vitrectomy, presence of culture and results of bacterial cultures, type of corneal incision, pres-ence of suture on corneal incision, presence of posterior capsule rupture, and surgeon’s experience in referred cases.

Results

Intravitreal antibiotic injection was given in all 35 cases, and vitrectomy was additionally performed in 30 of the cases. Statistically, none of the initially investigated factors affected final visual acuity. Coagulase-negative staphylococci including staphylococcus epidermidis were the most common organisms isolated during the study period.

Conclusions

No single factor investigated significantly affected the final visual acuity in postoperative endophthalmitis fol-lowing cataract surgery.

Keywords: Bacterial culture, Cataract surgery, Postoperative endophthalmitis

References

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Table 1.
Final visual acuity related to the presence of diabetes mellitus
Final visu ual acuity Total p-value*
Worse than 20/100 Above 20/100
DM (+) 2 7 9 0.376
DM (-) 10 16 26
Total 12 23 35

DM = diabetes mellitus.

* Pearson chi-square test.

Table 2.
Final visual acuity related to the visual acuity at the time of diagnosis
Final visual acuity Total p-value*
Worse than 20/100 Above 20/100
≤ LP 3 1 4 0.356
HM - FC 30 cm 7 16 23
20/1000 - 20/100 2 4 6
Above 20/100 0 2 2
Total 12 23 35

LP = light perception; HM = hand motion; FC = finger count.

* Fisher’s exact test.

Table 3.
Final visual acuity related to the duration between cataract surgery and diagnosis
Final visual acuity Total p-value*
Worse than 20/100 Above 20/100
Within 7 days 7 13 20 0.918
After 8 days 5 10 15
Total 12 23 35

* Pearson chi-square test.

Table 4.
Final visual acuity related to the methods of the treatment
Final visual acuity Total p-value*
Worse than 20/100 Above 20/100
IV Antibiotics injection only 0 5 5 0.081
IV Antibiotics injection with vitrectomy 12 18 30
Total 12 23 35

IV = intravitreal.

* Pearson chi-square test.

Table 5.
Final visual acuity related to the duration between diagnosis and pars plana vitrectomy
Final visual acuity Total p-value*
Worse than 20/100 Above 20/100
Within 7 days 6 10 16 0.765
After 8 days 6 8 14
Total 12 18 30

* Pearson chi-square test.

Table 6.
Frequency of organism according to the result of culture
Culture status Organism Number of eyes
No culture 7
Culture negative 9
Culture positive Gram positive 12
Staphylococcus epidermidis 5
Staphylococcus haemolyticus 2
Staphylococcus capitis 1
Streptococcus hemolyticus 1
Streptococcus sanguinis 1
Streptococcus mitis 1
Bacillus species 1
Gram negative 7
Stenotrophomonas maltophilia 2
Enterococcus faecalis 3
Morganella morganii ssp morganii 1
Achromobacter xylosoxidans 1
Total 35
Table 7.
Final visual acuity related to the result of the culture among the culture positive group
Final visual acuity Total p-value*
Worse than 20/100 Above 20/100
Gram (-) 2 5 7 0.829
Gram (+) 4 8 12
Total 6 13 19

* Pearson chi-square test.

Table 8.
Final visual acuity related to the type of incision site
Final visual acuity Total p-value*
Worse than 20/100 Above 20/100
Temporal clear corneal incision 11 21 32 1.00
Superior limbal corneal incision 1 1 2
Scleral tunnel incision 0 1 1
Total 12 23 35

* Fisher’s exact test.

Table 9.
Final visual acuity related to the presence of corneal incision suture
Final visual acuity Total p-value*
Worse than 20/100 Above 20/100
Suture (+) 6 11 17 0.903
Suture (-) 6 12 18
Total 12 23 35

* Pearson chi-square test.

Table 10.
Final visual acuity related to the presence of posterior capsule rupture
Final visual acuity Total p-value*
Worse than 20/100 Above 20/100
Rupture (+) 2 5 7 0.722
Rupture (-) 10 18 28
Total 12 23 35

* Pearson chi-square test.

Table 11.
Final visual acuity related to the experience of the surgeon among the referred cases
Final visual acuity Total p-value*
Worse than 20/100 Above 20/100
Shorter than 10 years 4 6 6 0.913
10 years or longer 8 11 19
Total 12 17 29

* Pearson chi-square test.

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