Factors associated with postoperative visual outcome in acute endophthalmitis after cataract surgery—a cross-sectional, analytical study

Abstract

Purpose
To identify predictors of visual outcome in patients with acute endophthalmitis following cataract surgery.

Methods
This cross-sectional study included consecutive patients with acute endophthalmitis following cataract surgery at our tertiary care center between January 2017 and June 2018. Baseline demographic details, surgical details, and treatment offered were extracted from the medical record, and patients were followed for 3 months after diagnosis and treatment for endophthalmitis. A good outcome was defined as visual acuity of greater than 6/12; a poor outcome, visual acuity of less than 6/60 on 3-month follow-up. The factors associated with these outcomes were analyzed.

Results
A total of 60 patients were included, of whom 32 (53%) had good visual outcome, and 11 (18%) had poor visual outcome. On univariate analysis, factors associated with good outcome were younger age at surgery, male sex, diabetes, absence of hypopyon, and absence of fibrillary membrane over the intraocular lens (IOL). Poor visual acuity at presentation, inability to visualize the optic disc on indirect ophthalmoscopy, and negative microbiological culture were associated with poor visual outcome. Stepwise logistic regression analysis showed that absent hypopyon (OR = 19.50; 95% CI, 2.87-132.14) and absent fibrillary membrane over the IOL (OR =15.0; 95% CI, 2.34-96.89) were independent factors for good visual outcome. Negative microbiological culture (OR = 18.67; 95% CI, 2.32-150.13) was the only independent factor associated with poor visual outcome.

Conclusions
The clinical findings at presentation and microbiological profile play an important role in determining the outcome in patients with acute post-cataract surgery endophthalmitis.