Postcataract surgery endophthalmitis in a Ghanaian population: incidence, risk factors and visual outcome after treatment

Abstract

Background: Post-operative endophthalmitis (POE) is a serious sight threatening complication after cataract surgery. There are no published data on the incidence and outcome of treatment of this condition in West Africa.

Objective: To estimate the incidence, risk factors and visual outcome of endophthalmitis post-cataract surgery in a Ghanaian population.

Design: A retrospective interventional case series.

Setting: Eye clinic, Korle-Bu Teaching Hospital, Accra.

Subjects: All patients who had undergone cataract surgery or secondary intraocular lens implantation in Korle Bu Teaching Hospital between February 2011 and January 2014.

Main outcome Measure: Proportion of patients who developed endophthalmitis.

Results: Six of 1032(0.58%) patients (4 males) had presumed endophthalmitis. Their median age was 34years, median time of onset of endophthalmitis was 17 days and the median follow up was 371.5 days. Four (0.39%) patients had acute POE and 2(0.19%) delayed POE. The incidence of culture proven acute POE and delayed POE were 2/1032(0.19%) and 1/1032(0.097%), respectively. Post-operative complications requiring a second surgical procedure was associated with increased risk of acute POE (p<0.0001) and posterior capsular rupture was associated with increased risk of delayed POE (p<0.0001). Three of 6(50%) patients with POE achieved a visual acuity of 6/9, one patient had visual acuity of hand motion and the other had acuity of non-perception of light at the last follow up visit.

Conclusion: The incidences of acute and delayed POE were 0.39% and 0.19%, respectively. Intraoperative and Post-operative complications of cataract surgery were associated with a higher risk of endophthalmitis in this population.