Surgical Techniques of Cataract Surgery and Subsequent Postoperative Endophthalmitis
Adisak Trinavarat MD*, La-ongsri Atchaneeyasakul MD*
Affiliation : * Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University
Objectives : To compare the incidence and characteristics of patients with endophthalmitis after extracapsular
cataract extraction (ECCE) to those after phacoemulsification
Materials and Methods : Records of patients receiving intravitreal antibiotic injection to treat endophthalmitis
after cataract surgery between Jan 2001 and Dec 2004 were reviewed. Demographic data and other charac-
teristics including associated diseases, details of cataract surgical procedure and intraoperative complica-
tion, onset of endophthalmitis after cataract surgery, presenting symptoms and signs of endophthalmitis, how
endophthalmitis was managed, causative organisms, duration of hospitalization and results of treatment were
collected. This information was compared between those of endophthalmitis patients after ECCE and those
after phacoemulsification.
Results : There were 5 cases who developed endophthalmitis after ECCE and 31 cases after phacoemulsification.
The incidence was 0.365% after ECCE and 0.279% after phacoemulsification (p = 0.589). Visual acuity (VA)
before cataract surgery in ECCE group was worse than the phacoemulsification group (median VA: counting
fingers vs 6/36, p = 0.001). Median onset of endophthalmitis was 8 days after ECCE and 6 days after
phacoemulsification. Presenting symptoms and signs were similar. Causative agents were identified in 4
(80%) and 14 (45%) cases in the ECCE and phacoemulsification groups respectively. Gram-positive bacteria
were the major cause of infection in both groups. Endophthalmitis caused by citrobacter sp. in ECCE group
and enterococcus or streptococcus sps. the phacoemulsification in the group ended up with enucleation or no
light perception.
Conclusion : The present study has not demonstrated an apparent difference between endophthalmitis after
ECCE and those after phacoemulsification. Endophthalmitis after either procedure can be managed as the
same condition.
Keywords : Endophthalmitis, Cataract surgery
