Incidence, management, and visual outcomes in pediatric endophthalmitis following cataract surgery by a single surgeon.

PURPOSE: To report the incidence of endophthalmitis following cataract surgery by a single surgeon in children and to describe its microbiological profile, management, and visual outcomes.

METHODS: The medical records of patients who underwent cataract surgery performed by a single surgeon between January 2000 and December 2012 were retrospectively reviewed to identify those with postoperative endophthalmitis. The primary goals of the study were to describe the incidence of endophthalmitis, microbiological profile, and measure visual acuity after management.

RESULTS: A total of 2,390 cataract surgeries were performed during the study period. The overall endophthalmitis rate during the study period was 0.376% (95% CI, 0.357-0.395). Of the 9 cases of postoperative endophthalmitis identified, 8 had a median duration of 2.5 days between time of surgery and diagnosis. The common presenting symptoms were pain and redness. Of the 5 cases in which early vitrectomy was performed, 4 showed good visual recovery at final follow-up visit. Both Gram-positive and Gram-negative organisms were seen equally. Culture-positive results were seen in 4 patients, the majority of which showed Acinetobacter calcoaceticus. Most of the organisms were resistant to ceftazidime.

CONCLUSIONS: Endophthalmitis following pediatric cataract surgery is rare but occurs rapidly and can cause severe loss of vision. Early recognition and treatment can help in salvaging the vision.