Objective: To study the infective endophthalmitis after phacoemulsification and to discuss the methods for prevention and treatment of this complication.
Methods: A retrospective analysis was performed on phacoemulsification with implantation of artificial lens underwent in 10 MaiGe Ophthalmological Centers during past 10 years (from 1993 to 2003).
Results: Among 63,372 cases (84,497 eyes) underwent the phacoemulsification, 14 cases suffered infective endophthalmitis with the incidence of 0.02%. In these 14 cases, 11 cases occurred before 1999 (78.6%). There were 5 cases of ruptured posterior lens capsule in these 14 cases (35.7%). Microbiological examination was performed in 11 cases (aqueous or vitreous sample), 7 cases showed positive results (63.6%), including 3 cases of staphylococcus epidermidis (42.8%), 1 case of pseudomonas aeruginosa (16.7%), 1 case of bacilli (16.7%) and 2 cases (33.4%) of fungus (yeast and candida albicans). After the treatment, the vision of 5 patients was recovered to 2.0 or more, 4 cases recovered to hand movement and light perception, enucleation was performed in 3 cases and atrophy of eyeballs occurred in 2 cases.
Conclusions: The attack rate of endophthalmitis after phacoemucification surgery is 0.02%. The main pathogen is staphylococcus epidermidis. Rupture of posterior lens capsule is one of the main risk factors of endophthalmitis. Observing the operative routine strictly pre-, during and post-operatively can reduce the occurrence of infective endophthalmitis.