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Endophthalmitis after Cataract Surgery in Korea: A Nationwide Study Evaluating Incidence and Risk Factors in a Korean Population

이종혁|김선웅|나상훈|김수한|유민희
연세대학교의과대학 (Yonsei University College of Medicine)|2019.05|Yonsei Medical Journal|제60권 제5호|pp. 467-473|DOI 10.3349/ymj.2019.60.5.467

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참고문헌

키워드

KoreaCataractendophthalmitisphacoemulsification
주제분류의학일반

초록

Purpose: To assess the nationwide rate of acute postoperative endophthalmitis (APE) after cataract extraction in Korea and toevaluate potential risk factors thereof. Materials and Methods: Nationwide insurance claims data from July 2014 to June 2017 were reviewed. All patients with phacoemulsificationor extracapsular/intracapsular cataract extraction were included. Exclusion criteria were combined glaucoma surgeryor total vitrectomy or when the patient had a history of intraocular foreign body. Results: In total, 1505103 cases (982203 patients) were included. APE developed in 953 cases (938 patients) with an overall incidenceof 0.063%. After adjusting for possible confounding factors, male sex [odds ratio (OR) 1.42; 95% confidence interval (CI)1.25–1.61; p<0.001], primary clinical setting, operations performed in non-major cities, usage of sutures (OR 2.82; 95% CI 2.13–3.74; p<0.001), anterior vitrectomy (OR 8.71; 95% CI 6.71–11.32; p<0.001), aphakic cataract surgery (OR 1.52; 95% CI 1.03–2.22; p=0.033), hypertension (OR 1.40; 95% CI 1.18–1.66; p<0.001), diabetes (OR 1.59; 95% CI 1.31–1.93; p<0.001), and chronic renal failure(OR 1.28; 95% CI 1.01–1.62; p=0.039) were found to be related to APE development. Conclusion: The incidence of APE after cataract extraction was consistent with reports from other studies. Additional research isneeded to determine the relationship of newly found risk factors, such as hypertension, primary clinical setting, chronic renalfailure, and usage of suturing, with APE development.

Abstract

Purpose: To assess the nationwide rate of acute postoperative endophthalmitis (APE) after cataract extraction in Korea and toevaluate potential risk factors thereof. Materials and Methods: Nationwide insurance claims data from July 2014 to June 2017 were reviewed. All patients with phacoemulsificationor extracapsular/intracapsular cataract extraction were included. Exclusion criteria were combined glaucoma surgeryor total vitrectomy or when the patient had a history of intraocular foreign body. Results: In total, 1505103 cases (982203 patients) were included. APE developed in 953 cases (938 patients) with an overall incidenceof 0.063%. After adjusting for possible confounding factors, male sex [odds ratio (OR) 1.42; 95% confidence interval (CI)1.25–1.61; p<0.001], primary clinical setting, operations performed in non-major cities, usage of sutures (OR 2.82; 95% CI 2.13–3.74; p<0.001), anterior vitrectomy (OR 8.71; 95% CI 6.71–11.32; p<0.001), aphakic cataract surgery (OR 1.52; 95% CI 1.03–2.22; p=0.033), hypertension (OR 1.40; 95% CI 1.18–1.66; p<0.001), diabetes (OR 1.59; 95% CI 1.31–1.93; p<0.001), and chronic renal failure(OR 1.28; 95% CI 1.01–1.62; p=0.039) were found to be related to APE development. Conclusion: The incidence of APE after cataract extraction was consistent with reports from other studies. Additional research isneeded to determine the relationship of newly found risk factors, such as hypertension, primary clinical setting, chronic renalfailure, and usage of suturing, with APE development.

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