title: The incidence of postoperative endophthalmitis after cataract surgery in China: a multicenter investigation of 2006-2011.
abstract: OBJECTIVE
  To estimate the cumulative incidence of postoperative endophthalmitis, identify risk factors and determine clinical outcomes in China.
  
  
  METHODS
  Medical records were reviewed for all patients with acute-onset endophthalmitis after cataract surgery from January 2006 to December 2011 at eight eye centres of tertiary care hospitals in China.
  
  
  RESULTS
  Sixty-six cases of presumed endophthalmitis occurred after 201 757 cataract surgeries, yielding a cumulative incidence of 0.033% (95% CI 0.025 to 0.041). Logistic regression analysis revealed that the risk of endophthalmitis increased with intraoperative communication with vitreous (multivariate OR 9.96; 95% CI 4.54 to 21.84; p<0.001). After a median follow-up of 153 days, best-corrected visual acuity in the affected eye was more than 20/70 in 29/65 (44.6%) patients, and more than 20/40 in 20/65 (30.8%). A predictor of good visual acuity was baseline acuity of counting fingers or better (OR 6.25; 95% CI 2.13 to 18.33). Of 64 cases, 25 (39.1%) were culture positive. Coagulase-negative Staphylococcus and Pseudomonas species were the most common organisms isolated, accounting for 72.0% of the culture-positive cases (18/25). Two eye centres that used a combination of a high concentration vancomycin (1 mg/0.1 mL intracameral vancomycin injection or 100 µg/mL vancomycin in irrigating solution) and tobramycin as infection prophylaxis achieved a lower incidence of endophthalmitis than other centres (p<0.001).
  
  
  CONCLUSIONS
  The incidence of acute postoperative endophthalmitis after cataract surgery in tertiary care hospitals of China was 0.033%. Intraoperative communication with vitreous was a major risk factor for developing endophthalmitis. Prophylactic use of a high-concentration vancomycin and tobramycin may play a positive role in the prevention of postoperative endophthalmitis after cataract surgery.
authors.affiliation: Eye Center, 2nd Affiliated Hospital of Medical College, Zhejiang University, , Hangzhou, Zhejiang, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Yao
authors.forename: Yanan
authors.initials: Y
authors.lastname: Zhu
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Zhu
authors.forename: Jianjun
authors.initials: J
authors.lastname: Wu
authors.forename: Yizhi
authors.initials: Y
authors.lastname: Liu
authors.forename: Yi
authors.initials: Y
authors.lastname: Lu
authors.forename: Yansheng
authors.initials: Y
authors.lastname: Hao
authors.forename: Yongzhen
authors.initials: Y
authors.lastname: Bao
authors.forename: Jian
authors.initials: J
authors.lastname: Ye
authors.forename: Yusen
authors.initials: Y
authors.lastname: Huang
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Li
authors.forename: Xingchao
authors.initials: X
authors.lastname: Shentu
authors.forename: Yibo
authors.initials: Y
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D009877:Endophthalmitis / Q000453:epidemiology* / Q000209:etiology; D015818:Eye Infections, Bacterial / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity; D055815:Young Adult
keywords: Epidemiology