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Major outbreak of endophthalmitis after cataract surgery: a retrospective cohort study in northern Brazil

Major outbreak of endophthalmitis after cataract surgery: a retrospective cohort study in northern Brazil

Priscilla Perez da Silva Pereira1; Andriely Alayne Carvalho Sabini2; Rosa Maria Ferreira de Almeida2; Daniela Oliveira Pontes2; Márcia Maria Bezerra Mororó Alves3; Viviane Alves de Sousa3; Magzan da Silva Azevedo3; Adalgiza de Souza Botelho3; Surlange Freire Ramalhaes3; Edilson Batista da Silva3; Maria Artele da Gama Baldez3; Elizabeth Carmen Duarte1

DOI: 10.5935/0004-2749.2025-0175

ABSTRACT

PURPOSE: Endophthalmitis is one of the most important adverse events after cataract surgery, as it can lead to total vision loss. This study aimed to describe the occurrence of endophthalmitis after phacoemulsification with intraocular lens implantation in patients treated in a community setting in Porto Velho, Rondônia, Brazil.
METHODS: This retrospective cohort study was conducted using a database of 649 medical records of patients who underwent surgery and were followed for three months. Poisson regression analysis was used to estimate relative risks and 95% confidence intervals (95% CIs).
RESULTS: The incidence of confirmed endophthalmitis was 11.94% (95% CI, 9.50-14.76), while the incidence of confirmed and probable cases was 20.50% (95% CI, 17.52-23.73). For confirmed cases, bilateral surgery and the use of lens model 3 were identified as risk factors for endophthalmitis, whereas age over 70 yr and preoperative antibiotic use were protective factors. For confirmed and probable cases, brown and yellow skin color, bilateral surgery, and the use of lens model 3 were also identified as risk factors. Gram-negative bacteria were the predominant etiological agents, and corneal edema was the main clinical manifestation. The mean duration of treatment was eight days, and 27.12% of patients used antibiotics.
CONCLUSION: The incidence observed was substantially higher than that reported in the literature, with a predominance of Gram-negative agents and an association with bilateral surgeries and the Eyeol intraocular lens model. These findings reinforce the need for continuous epidemiological surveillance and the implementation of specific biosafety and infection control protocols during cataract surgery campaigns.

Keywords: Endophthalmitis; Disease outbreaks; Phacoemulsification; Lens implantation, intraocular; Lenses, intraocular; Cataract; Risk factors; Anti-bacterial agents


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