Bacterial endophthalmitis after small-incision cataract surgery: effect of incision placement and intraocular lens type

To determine whether endophthalmitis after small-incision cataract surgery is affected by the incision site (superior sclerocorneal versus temporal cornea) or the foldable intraocular lens (IOL) material (silicone versus acrylic). Multicenter study. Patients who had small-incision cataract surgery a...

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Veröffentlicht in:Journal of cataract and refractive surgery 2003, Vol.29 (1), p.20-26
Hauptverfasser: Nagaki, Yasunori, Hayasaka, Seiji, Kadoi, Chiharu, Matsumoto, Masayuki, Yanagisawa, Shuiichiro, Watanabe, Kazuhiko, Watanabe, Konomi, Hayasaka, Yoriko, Ikeda, Nariko, Sato, Shoichi, Kataoka, Yasushi, Togashi, Mika, Abe, Tomohiro
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container_issue 1
container_start_page 20
container_title Journal of cataract and refractive surgery
container_volume 29
creator Nagaki, Yasunori
Hayasaka, Seiji
Kadoi, Chiharu
Matsumoto, Masayuki
Yanagisawa, Shuiichiro
Watanabe, Kazuhiko
Watanabe, Konomi
Hayasaka, Yoriko
Ikeda, Nariko
Sato, Shoichi
Kataoka, Yasushi
Togashi, Mika
Abe, Tomohiro
description To determine whether endophthalmitis after small-incision cataract surgery is affected by the incision site (superior sclerocorneal versus temporal cornea) or the foldable intraocular lens (IOL) material (silicone versus acrylic). Multicenter study. Patients who had small-incision cataract surgery at Toyama Medical and Pharmaceutical University Hospital and affiliated hospitals from March 1998 to March 2001 were examined prospectively. The patients were randomized into 3 groups. In Group A, an acrylic IOL (MA60BM, Alcon) was implanted through a temporal corneal incision. In Group B, an acrylic IOL (MA60BM) was implanted via a superior sclerocorneal incision. In Group C, a silicone poly(methyl methacrylate) IOL (SI-40NB, Allergan) was implanted via a superior sclerocorneal incision. Each patient was followed for more than 6 months. Initially, 7622 patients (12 317 eyes) agreed to participate in the study. The final study included 3831 eyes in Group A, 3901 eyes in Group B, and 3863 eyes in Group C. Postoperative endophthalmitis was diagnosed clinically in 11 eyes (0.29%) in Group A, 2 (0.05%) in Group B, and 2 (0.05%) in Group C. Endophthalmitis proven by culture was found in 9 eyes in Group A, 2 in Group B, and 2 in Group C. The incidence of endophthalmitis in Group A was higher than in the other groups. The incidence of endophthalmitis in Group B was similar to that in Group C. The relative risk of postoperative endophthalmitis proven by culture in Groups B and C was 4.6 times ( P = .037) lower than in Group A. The findings suggest that a temporal corneal incision may lead to an increased risk of postoperative endophthalmitis and that the IOL material does not affect the incidence of this complication.
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Multicenter study. Patients who had small-incision cataract surgery at Toyama Medical and Pharmaceutical University Hospital and affiliated hospitals from March 1998 to March 2001 were examined prospectively. The patients were randomized into 3 groups. In Group A, an acrylic IOL (MA60BM, Alcon) was implanted through a temporal corneal incision. In Group B, an acrylic IOL (MA60BM) was implanted via a superior sclerocorneal incision. In Group C, a silicone poly(methyl methacrylate) IOL (SI-40NB, Allergan) was implanted via a superior sclerocorneal incision. Each patient was followed for more than 6 months. Initially, 7622 patients (12 317 eyes) agreed to participate in the study. The final study included 3831 eyes in Group A, 3901 eyes in Group B, and 3863 eyes in Group C. Postoperative endophthalmitis was diagnosed clinically in 11 eyes (0.29%) in Group A, 2 (0.05%) in Group B, and 2 (0.05%) in Group C. 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Endophthalmitis proven by culture was found in 9 eyes in Group A, 2 in Group B, and 2 in Group C. The incidence of endophthalmitis in Group A was higher than in the other groups. The incidence of endophthalmitis in Group B was similar to that in Group C. The relative risk of postoperative endophthalmitis proven by culture in Groups B and C was 4.6 times ( P = .037) lower than in Group A. The findings suggest that a temporal corneal incision may lead to an increased risk of postoperative endophthalmitis and that the IOL material does not affect the incidence of this complication.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12551662</pmid><doi>10.1016/S0886-3350(02)01483-9</doi><tpages>7</tpages></addata></record>
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subjects Acrylates
Aged
Aged, 80 and over
Bacterial Infections - etiology
Biological and medical sciences
Cataract Extraction - adverse effects
Cataract Extraction - methods
Cornea - surgery
Endophthalmitis - epidemiology
Endophthalmitis - microbiology
Equipment Design
Female
Humans
Incidence
Lenses, Intraocular - adverse effects
Male
Medical sciences
Polymethyl Methacrylate
Prospective Studies
Sclera - surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the eye and orbit
title Bacterial endophthalmitis after small-incision cataract surgery: effect of incision placement and intraocular lens type
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