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2002 Ocular Microbiology and Immunology Group, Abstract 11

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Increased Risk of Endophthalmitis in Clear Cornea Cataract Surgery
Snyder, RW M.D., Ph.D., Nedrud, Chad M.D., Twelker, Dan O.D., Ph.D.
University of Arizona Department of Ophthalmology

Purpose: To determine the relative risk of endophthalmitis in clear cornea cataract
surgery (CCCS) based on a systematic literature review.

Methods: A Medline Search of the literature published in English or with English abstracts between 1990 and 2002 was performed using a combination of key words. A binomial probability distribution of the average ophthalmologist seeing zero, 1, or 2 cases of endophthalmitis each year was calculated based on the estimate of risk for
endophthalmitis when CCCS and scleral tunnel incisions were compared.

Results: We found 3 large studies (>1,842 cases of CCCS) where the incidence of endophthalmitis in CCCS was 2.6, 3.3, and 22 times greater than with a scleral tunnel incision. If the incidence were three times greater with CCCS an Ophthalmologist doing 300 cases per year would have a probability of 0.42 of seeing no cases, 0.36 of seeing 1 case, and 0.16 of seeing 2 cases.

Conclusions: The relative risk of endophthalmitis may be 3 or more times greater with CCCS. This may be an uncommon occurrence and hence unapparent for most individual eye surgeons. However, this could account for 4000 or more additional cases of endopthalmitis in the US per year and warrants attention to determine the risk factors.

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