Characteristics after cataract extraction or secondary lens implantation among patients screened for the Endophthalmitis Vitrectomy Study.
OBJECTIVE
This report describes the presenting clinical ophthalmic features and historical findings in patients with a clinical diagnosis of endophthalmitis after cataract extraction or secondary lens implant surgery screened for enrollment in the Endophthalmitis Vitrectomy Study (EVS).


METHODS
Clinic-based, cross-sectional study.


METHODS
Eight hundred fifty-four patients suspected to have endophthalmitis after cataract extraction or secondary lens implantation.


METHODS
As part of the screening process for the study, an eye examination, a medical history, and demographic data were recorded in standardized form for all patients with endophthalmitis after cataract extraction or secondary lens implant surgery referred to the clinical centers, regardless of whether the patient met entry criteria.


METHODS
Demographics, presenting signs, and symptoms.


RESULTS
The median age of individuals presenting with suspected bacterial endophthalmitis was 75 years (range, 9-100 years). Most of those screened (57.7%) were women. Seventy-nine percent of patients sought treatment within 6 weeks of surgery. Blurred vision, conjunctival injection, pain, and lid swelling were the predominant presenting symptoms in order of prevalence. Ocular pain and hypopyon, widely regarded as diagnostic of endophthalmitis, were each absent in 25% of patients. The median hypopyon height, when present, was 1.5 mm.


CONCLUSIONS
The classic presentation of postoperative endophthalmitis includes reduced vision, conjunctival hyperemia, pain, hypopyon, and lid swelling within days after cataract surgery or secondary lens implantation. These were the prominent clinical findings in the EVS as well. Because pain and hypopyon, although common, were not always present, clinicians must be vigilant in postsurgical monitoring of patients.
Wisniewski
S R
SR
Epidemiology Data Coordinating Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. wisniew@edc.gsph.pitt.edu
Capone
A
A
Kelsey
S F
SF
Groer-Fitzgerald
S
S
Lambert
H M
HM
Doft
B H
BH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000009:adverse effects*; D002648:Child; D003229:Conjunctival Diseases / Q000175:diagnosis; D003430:Cross-Sectional Studies; D009877:Endophthalmitis / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D005141:Eyelid Diseases / Q000175:diagnosis; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000175:diagnosis; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis; D013492:Suppuration / Q000175:diagnosis; D013997:Time Factors; D014786:Vision Disorders / Q000175:diagnosis; D014821:Vitrectomy