Mortality after endophthalmitis following contemporary phacoemulsification cataract surgery

Importance: To determine if endophthalmitis following cataract surgery is linked to increased mortality.

Background: Increased mortality has been linked to patients with cataract and cataract surgery. We tested the hypothesis that post-cataract endophthalmitis has a greater risk of death than pseudophakes who do not develop this complication.

Design: Case-control study conducted in a tertiary public hospital.

Participants: The study group comprised 50 consecutive patients with post-cataract endophthalmitis, and these were matched with selected controls.

Methods: Patients with endophthalmitis following cataract surgery were identified from a prospective electronic surgical database. Subsequently, it was determined if the patient was deceased at the time of sequestration (September 2015), and the date of death was recorded. A previously described population who had undergone cataract surgery in the same facility was selected as a control group, and the population was case-matched in terms age, gender, presence or absence of diabetes and/or hypertension.

Main outcome measures: The median survival rates were determined for the control group and the patients with post-cataract endophthalmitis.

Results: Fifty patients were identified as undergoing endophthalmitis post-cataract surgery, and 48 (n = 48) met inclusion criteria (mean age 72 years ±12 SD with 30:18 F:M); 17% were diabetic, and 50% had systemic hypertension. No statistically significant difference in median survival between the study and control cases was identified (100 months (95% confidence interval 86-114) vs. 106 months (95% confidence interval 66-146), respectively, P = 0.756).

Conclusions and relevance: Post-cataract endophthalmitis was not associated with an increased rate of mortality in this study.