Notable Outcomes: Cataract Surgery and Endophthalmitis Complications

Dec 08, 2021 12:00 PM


Recent outcomes reflect the John A. Moran Eye Center's dedication to providing exceptional care while fulfilling its teaching role as part of an academic medical center. Moran’s cataract surgery and endoph­thalmitis complication rates include cases performed with fellows or residents, or both.

Moran researchers have also published some of the most influential studies about cataract surgery techniques, safety, and intraoperative complications.*

These complication rates for cataract surgery** and endophthalmitis, a potentially blinding infection of the tissues or fluids inside the eye following surgery or ophthalmic injections, are among the lowest when compared to known national and international benchmarks.

Cataract Surgery

Graphic showing cataract surgery complications

Cataract Surgery-Induced Endophthalmitis

There were no cases of culture-positive endophthalmitis following uncomplicated cataract surgery in 2020. One possible case investigated in a complicated cataract surgery procedure returned with a negative culture. It was atypical in that it occurred more than five weeks after surgery. Visual outcome was excellent, improving from 20/150 best corrected, to 20/30 uncorrected. This results in an incidence of 0.018% for cataract surgery in 2020.*

All-Specialties Endophthalmitis Data

A graphic showing endophthalmitis complication rates.

Comprehensive Data Collection

Casting a wide net, Moran’s QI group and division representatives, University of Utah Health Infection Prevention Department, and others review every potential case of endophthalmitis in the U of U Health hospital system. The team reviews all ocular specimens submitted for culture, all patients receiving intraocular antibiotics, and all cases coded as endophthalmitis.

Because Moran is part of a large referral hospital system, there were numerous “external” cases of endophthalmitis, not related to Moran’s facility, reviewed in 2020.

Moran’s review of 255 total potential endophthalmitis cases in 2020 detected 8 positive external referral cases, including 1 with post-operative endophthalmitis, 1 with indolent endophthalmitis, and 6 with endogenous endophthalmitis. There were 4 external cases of traumatic endophthalmitis. Of the 4 internal Moran post-operative cases reviewed, 3 came back with negative cultures. Because of the possibility of false-negative culture results, Moran includes negative cultures in final complication rate totals for comprehensive data analysis. The 1 positive culture surgery-induced endophthalmitis case occurred following a vitreoretinal procedure.

By seeking cases from numerous sources and locations, Moran is rigorous in including not only potential surgical complications, but also traumatic and endogenous cases.

Footnotes

* Among the studies: “Cataract Surgery Complications in 1 Year at an Academic Institution.” MF Pingree, AS Crandall, RJ Olson. Journal of Cataract & Refractive Surgery.1999 May;25(5):705-8.

** Available benchmark data includes a reported 2020 cataract surgery intraoperative complication rate by Cleveland Clinic Cole Eye Institute of 0.85%. Massachusetts Eye and Ear reported a 2019 cataract surgery intraoperative complication rate of 1.6%; comparable 2020 data from the institution was not available at time of publishing.

*** Multiple studies in the U.S., Europe, and Asia, put the incidence of post-cataract-surgery endophthalmitis from 0.03% to 0.07%, with the mean at about 1 in 1,500.

vision research