title: Bacterial endophthalmitis after small-incision cataract surgery. effect of incision placement and intraocular lens type.
abstract: OBJECTIVE
  To determine whether endophthalmitis after small-incision cataract surgery is affected by the incision site (superior sclerocorneal versus temporal cornea) or the foldable intraocular lens (IOL) material (silicone versus acrylic).
  
  
  METHODS
  Multicenter study.
  
  
  METHODS
  Patients who had small-incision cataract surgery at Toyama Medical and Pharmaceutical University Hospital and affiliated hospitals from March 1998 to March 2001 were examined prospectively. The patients were randomized into 3 groups. In Group A, an acrylic IOL (MA60BM, Alcon) was implanted through a temporal corneal incision. In Group B, an acrylic IOL (MA60BM) was implanted via a superior sclerocorneal incision. In Group C, a silicone poly(methyl methacrylate) IOL (SI-40NB, Allergan) was implanted via a superior sclerocorneal incision. Each patient was followed for more than 6 months.
  
  
  RESULTS
  Initially, 7622 patients (12 317 eyes) agreed to participate in the study. The final study included 3831 eyes in Group A, 3901 eyes in Group B, and 3863 eyes in Group C. Postoperative endophthalmitis was diagnosed clinically in 11 eyes (0.29%) in Group A, 2 (0.05%) in Group B, and 2 (0.05%) in Group C. Endophthalmitis proven by culture was found in 9 eyes in Group A, 2 in Group B, and 2 in Group C. The incidence of endophthalmitis in Group A was higher than in the other groups. The incidence of endophthalmitis in Group B was similar to that in Group C. The relative risk of postoperative endophthalmitis proven by culture in Groups B and C was 4.6 times (P =.037) lower than in Group A.
  
  
  CONCLUSIONS
  The findings suggest that a temporal corneal incision may lead to an increased risk of postoperative endophthalmitis and that the IOL material does not affect the incidence of this complication.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan. ophthal@ms.toyama-mpu.ac.jp
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Nagaki
authors.forename: Seiji
authors.initials: S
authors.lastname: Hayasaka
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kadoi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Shuiichiro
authors.initials: S
authors.lastname: Yanagisawa
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Watanabe
authors.forename: Konomi
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Hayasaka
authors.forename: Nariko
authors.initials: N
authors.lastname: Ikeda
authors.forename: Shoichi
authors.initials: S
authors.lastname: Sato
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kataoka
authors.forename: Mika
authors.initials: M
authors.lastname: Togashi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Abe
mesh_terms: D000179:Acrylates; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000209:etiology*; D002387:Cataract Extraction / Q000009:adverse effects* / Q000379:methods; D003315:Cornea / Q000601:surgery; D009877:Endophthalmitis / Q000453:epidemiology / Q000382:microbiology*; D004867:Equipment Design; D005260:Female; D006801:Humans; D015994:Incidence; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008297:Male; D019904:Polymethyl Methacrylate; D011446:Prospective Studies; D012590:Sclera / Q000601:surgery
chemical_list: D000179:Acrylates; D019904:Polymethyl Methacrylate