Incidence and clinical characteristics of acute infectious endophthalmitis after approximately 2.03 million cataract surgeries in China over a 5-year period (2017-2021).

PURPOSE: To analyze the incidence and clinical characteristics of acute infectious endophthalmitis after approximately 2.03 million cataract surgeries in 448 hospitals in China over a 5-year period (2017–2021). METHODS: Retrospective, multi-center, cross-sectional study. Eyes developing acute infectious endophthalmitis after 2,026,416 cataract surgeries in 448 Aier eye hospitals in Mainland China from January 2017 to December 2021 were collected, and surgical methods and intraocular lens (IOL) types of the patients were analyzed. There was no prophylactic antibiotic administered routinely in the anterior chamber at the end of the cataract procedures.The conjunctival capsule was disinfected with 5% povidone iodine during surgery for at least 3 min.The incidence of postoperative acute infectious endophthalmitis was studied. Data such as operation time; hospital level; patient general condition; eye conditions; endophthalmitis onset time; and symptoms, diagnosis, treatment, and prognosis of visual acuity were analyzed. RESULTS: From 2017 to 2021, Aier eye hospitals in Mainland China completed 2,026,416 cataract surgeries, with 328 eyes developing acute infectious endophthalmitis—an overall incidence of 0.0162% in 5 years. A statistically significant difference in the incidence of endophthalmitis was observed among the four IOL implantation groups (PMMA, Foldable, Aspheric, and Premium IOLs) (p = 0.004). The PMMA IOL group had the highest incidence (0.0215%), compared to Foldable (0.0135%), Aspheric (0.0154%), and Premium IOLs (0.0212%).There was no statistically significant difference in the incidence among the different months, surgical procedures, and hospital levels. The mean age of patients with endophthalmitis was 70.73 ± 10.42 years. The average time of onset of endophthalmitis was 6.64 ± 6.46 days, with 78.35% of patients developing endophthalmitis within 7 days. The microbial culture positive rate of eye specimens was 17.21% in 42 cases, with Staphylococcus epidermidis (33.33%) having the highest detection rate. Visual acuity improved significantly following endophthalmitis treatment. CONCLUSIONS: The incidence of acute infectious endophthalmitis after approximately 2.03 million cataract surgeries in 448 Aier eye hospitals in China from 2017 to 2021 remained at low rate. Early discovery, diagnosis, and treatment are crucial to improve the visual prognosis of patients with endophthalmitis through analysis of influencing factors and clinical characteristics.