Acute postoperative endophthalmitis after phacoemulsification in a private ophthalmic surgical group.

Purpose: To analyze the incidence, causes, risk factors and treatment of acute postoperative endophthalmitis (POE) after phacoemulsification in a private ophthalmological group.

Design: Uncontrolled retrospective observational study of all cases of POE over 22 years.

Material And Methods: 369,476 eyes were included after phacoemulsification in 41 surgical centers of the Clínica Baviera-AIER EYE Group from 2002 to 2023. POE cases were reviewed.

Results: The general group was divided into two: group A (2002-2007), with vancomycin in the intracameral irrigation flow (27,705 eyes); Group B (2008-2023), with intracameral cefuroxime (341,771 eyes). 31 cases of POE were found (incidence, 0.0084%); 5 in group A (0.018%) and 26 in group B (0.0076%) (P = .314), with a mean age of 67.3 years (14 men and 17 women). Cultures were positive in 14 cases in Groups A and B. Treatment was based on intravitreal antibiotics and vitrectomy. The mean time to symptom onset was 6.76 days and the mean time to resolution was 120.7 days. 12 eyes achieved corrected distance visual acuity ≥ 20/40.

Conclusions: The incidence of POEwas 0.0084% (0.0181% in group A and 0.0076% in group B). The probability of having POE in group A was 2.37 times greater than in group B (OR: 2.37; 95% CI: 0.71-6.2; P = .079). The only significant risk factor for POE was posterior capsular rupture.