Endophthalmitis na cataractchirurgie in Nederland in 2008

Purpose: Accurate figures concerning endophthalmitis are not known in the Netherlands. A positive effect of the administration of intracameral cefuroxime in cataract surgery was shown in several studies outside of the Netherlands. The purpose of this study is to map all cases of endophthalmitis after cataract surgery in the Netherlands in 2008 and to analyze the possible role of the use of peroperative intracameral cefuroxime. Design: Multicenter retrospective observational study. Patients: All patients who had cataract surgery carried out in 2008 in the Netherlands and developed an endophthalmitis afterwards. Methods: All patients who have had an endophthalmitis after cataract surgery were traced. With co-operation of all clinics in the Netherlands, where patients with endophthalmitis are treated, the cohort was compiled. Using a scorecard all data on patients who lived through an endophthalmitis was collected. This data was edited with SPSS 16.0 and Microsoft Office Excel 2007. Results: In total around 148,000 patients had cataract surgery carried out in the Netherlands in 2008. In the postoperative process 108 casus an endophthalmitis occurred (0.073 %). The most cultured bacterium was the group of Staphylococci (N=39, 39.36 %) (coagulase negative staphylococ (CNS), epidermidis, aureus, gram-positive). The average best corrected visual acuity after infection was 0.41. After infection 12 patients (11.1 %) were left with a blind eye. In 38 patients (35.2 %) the best corrected visual acuity at the final follow-up was LP+ to 0.3. At the final follow-up 10 patients (9.3 %) had a best corrected visual acuity of 0.3 to 0.5. In 47 patients the best corrected visual acuity at the final follow-up was ≥ 0.5. Information about the use of intracameral cefuroxime was detected in 82 patients (75.9 %) off all cases. In three patients (1.9 %) this antibiotic was administered. Conclusion: The incidence of endophthalmitis after cataract surgery in the Netherlands in 2008 is 0.078 %. Our study is likely to support the suggestion that there is a positive prophylactic effect of administrating cefuroxime. However our study contains too little data to statistically analyze this effect. Therefore further investigations are necessary to prove this suggestion.