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Baseline predictive factors of visual prognosis in acute bacterial postcataract endophthalmitis

Session Details

Session Title: Uveitis & Intraocular Tumours

Session Date/Time: Friday 27/09/2013 | 14:30-16:00

Paper Time: 15:26

Venue: Hall C (Level 1)

First Author: C.Chiquet FRANCE

Co Author(s):    P. Cornut   A. Combey de Lambert   N. Campolmi   A. Bron     

Abstract Details

Purpose:

To identify baseline factors of visual prognosis in patients with acute endophthalmitis following cataract surgery.

Setting:

University Hospital of Grenoble, Dijon, Lyon, and Saint-Etienne

Methods:

99 patients were consecutively and prospectively enrolled from four academic hospitals. Factors related to the cataract surgery (complications), the initial clinical presentation, and the microbiological diagnosis were analyzed to determine the effect on the final visual outcome, defined as poor (<20/100) or good (≥20/40) using univariate and multivariate analysis.

Results:

The significant baseline factors (at presentation) for good visual outcome (45% of the series) were the winter season, absence of complications during cataract surgery, initial visual acuity (VA), microbiological investigations revealing no microorganism or a coagulase-negative Staphylococcus sp. (CNSP), and fundus visibility. Quantitative factors associated with a good clinical prognosis were shorter duration of cataract surgery, younger age, and a hypopyon equal to or less than 1.5 mm. Significant factors associated with poor visual outcome were infection of the right eye, initial VA, corneal edema, hypopyon larger than 1.5 mm, detection of bacterial species other than a CNSP, and the absence of fundus visibility. Multiple logistic regression analysis showed that high bacterial virulence was the only independent factor (odds ratio [OR]= 14, 95% confidence interval (CI): 2.7–71, p=0.001) for poor visual outcome. On the other hand, low bacterial virulence (OR=0.1, 95%CI: 0.03–0.6, p=0.01) and the absence of complications during cataract surgery (OR=0.07, 95%CI: 0.01–0.4, p=0.003) were independent factors for good VA.

Conclusions:

Most clinical outcome factors in acute postcataract endophthalmitis were identified at presentation. The bacterial virulence level was the main predictive factor of final visual prognosis.

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