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2001 Ocular Microbiology and Immunology Group, Abstract 10

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Endophthalmitis after Cataract Surgery: Clear Cornea Versus Scleral Tunnel Wounds
G. Bohigian, B. Cooper and N. Holekamp
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO

Purpose: To determine if clear corneal incision is a risk factor for endophthalmitis compared to a scleral tunnel incision.

Methods: A retrospective case control study of all culture-positive endophthalmitis following cataract surgery from a tertiary referral center from January 1, 1997 through December 31, 2000 was performed. A control group was established by studying the practice pattern of types of wound closures in the referring community during this time period.

Results: Thirty-eight cases of culture-positive endophthalmitis were identified over the four-year period of this study. Seventeen (45%) had clear corneal incision and 21 (55%) had scleral tunnel incision. However, endophthalmitis was seen in a disproportionally higher number of clear cornea cases when compared to the control base of the community practice pattern. Only 20% of the representative cataract surgery cases from the referring community were found to have a clear corneal incision during this four-year period. Thus the relative risk of endophthalmitis was higher in patients with clear cornea than scleral tunnel incision. A clear corneal incision was found to be a risk factor wh en compared to scleral tunnel (p = 0.0017). Organisms, methodology and pathophysiology will be discussed.

Conclusions: In this retrospective case-controlled study, clear corneal incisions were found to be a statistically significant risk factor for acute post-cataract surgery endophthalmitis when compared to scleral tunnel incision.

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