Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 1997
Bacterial endophthalmitis following extracapsular cataract extraction: recommendations for early detection.
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Lam S R, Tuli R, Menezes A, Devenyi R G
Аннотация
OBJECTIVE: To determine the time between the onset of symptoms of endophthalmitis after cataract extraction and presentation to an ophthalmologist and to determine the spectrum of organisms responsible for postoperative endophthalmitis.
DESIGN: Case series.
SETTING: Tertiary care vitreoretinal service in Toronto.
PATIENTS: Thirty-three patients with early (presentation within 2 weeks of surgery) endophthalmitis following extracapsular cataract extraction and intraocular lens implantation performed between January 1989 and December 1992.
OUTCOME MEASURES: Time to presentation to an ophthalmologist, duration of symptoms, culture results.
RESULTS: Twenty-two patients (66.7%) were documented to experience identifiable symptoms of endophthalmitis before presentation to their ophthalmologist; the mean time of onset of symptoms was 3.6 (standard deviation [SD] 1.7) days after surgery. Of the 22 patients 16 (72.7%) became symptomatic by the fourth postoperative day, and 21 (95.4%) experienced symptoms by the fifth postoperative day. The mean delay between onset of symptoms and presentation was 1.9 (SD 1.6) days. Bacteria were identified in 27 cases (81.8%), confirmed by culture in 23 cases (69.7%). The organisms were gram-positive in 25 (92.6%) of the 27 cases, and coagulase-negative Staphylococcus predominated.
CONCLUSIONS: In our series a considerable delay existed between the development of symptoms of endophthalmitis following extracapsular cataract extraction and clinical diagnosis. This delay could be minimized by scheduling routine postoperative visits at 1 and 4 days following cataract surgery.
DESIGN: Case series.
SETTING: Tertiary care vitreoretinal service in Toronto.
PATIENTS: Thirty-three patients with early (presentation within 2 weeks of surgery) endophthalmitis following extracapsular cataract extraction and intraocular lens implantation performed between January 1989 and December 1992.
OUTCOME MEASURES: Time to presentation to an ophthalmologist, duration of symptoms, culture results.
RESULTS: Twenty-two patients (66.7%) were documented to experience identifiable symptoms of endophthalmitis before presentation to their ophthalmologist; the mean time of onset of symptoms was 3.6 (standard deviation [SD] 1.7) days after surgery. Of the 22 patients 16 (72.7%) became symptomatic by the fourth postoperative day, and 21 (95.4%) experienced symptoms by the fifth postoperative day. The mean delay between onset of symptoms and presentation was 1.9 (SD 1.6) days. Bacteria were identified in 27 cases (81.8%), confirmed by culture in 23 cases (69.7%). The organisms were gram-positive in 25 (92.6%) of the 27 cases, and coagulase-negative Staphylococcus predominated.
CONCLUSIONS: In our series a considerable delay existed between the development of symptoms of endophthalmitis following extracapsular cataract extraction and clinical diagnosis. This delay could be minimized by scheduling routine postoperative visits at 1 and 4 days following cataract surgery.