Influence of intraocular lens material on the development of acute endophthalmitis after cataract surgery?
OBJECTIVE
To investigate the causal relationship between acute postoperative endophthalmitis (POE) after cataract surgery and the biomaterial properties of the intraocular lens (IOLs) implanted.


METHODS
This retrospective cohort study included all patients who had undergone cataract surgery with IOL implantation at the Lyon Croix-Rousse University Hospital between 1st January 1994 and 31st December 2004. Details respecting the type of IOL implanted (material and manufacturer) were meticulously recorded. The number of patients presenting with POE within 6 weeks of cataract surgery was documented together with their medical characteristics. These data were then compared, and Fisher's exact test was used to establish the significance of any apparent associations.


RESULTS
Eight of the 5837 eyes manifested acute POE (0.14%). Seven of these were composed of polymethylmethacrylate (PMMA) and one of heparinized PMMA. Patients with PMMA IOLs carried a higher risk of developing POE than did those implanted with either heparinized PMMA (P=0.001), hydrophilic acrylic, or hydrophobic acrylic IOLs (P=0.002).


CONCLUSIONS
The incidence of acute POE after cataract surgery in our hospital is similar to that currently reported for other institutions in developed countries. Our results add further evidence that IOL material and type are factors contributing to the risk to develop an acute POE after cataract surgery, and that PMMA IOLs may be associated with an increased risk of POE.
Kodjikian
L
L
Department of Ophthalmology, Croix-Rousse Hospital, University of Lyon I Claude Bernard, Lyon, France. kodjikian.laurent@wanadoo.fr
Beby
F
F
Rabilloud
M
M
Bruslea
D
D
Halphen
I
I
Fleury
J
J
Grange
J-D
JD
Garweg
J G
JG
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D002387:Cataract Extraction / Q000009:adverse effects*; D009877:Endophthalmitis / Q000209:etiology*; D015818:Eye Infections, Bacterial / Q000209:etiology; D005260:Female; D006801:Humans; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects; D019904:Polymethyl Methacrylate / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors
D001672:Biocompatible Materials; D019904:Polymethyl Methacrylate