PubMed ID: 41985695
Author(s): Chaaya C, Goldberg EA, Ross CJ, Zhang YS, Fahey JD, Zhang S, Meshkin RS, Hoyek S, Pandiri S, Elze T, Lorch AC, Miller JB, Miller JW, Singh RP, Patel NA; IRIS® Registry Analytic Center Consortium. Comparative Endophthalmitis Rates in Adult and Pediatric Patients across Various Ophthalmic Procedures: An IRIS® Registry Analysis. Ophthalmology. 2026 Apr 14:S0161-6420(26)00250-2. doi: 10.1016/j.ophtha.2026.04.011. Epub ahead of print. PMID: 41985695.PMID 41985695
Journal: Ophthalmology
Purpose: To evaluate the incidence of endophthalmitis after ophthalmic surgery using a national ophthalmic registry.
Design: Retrospective clinical cohort study.
Participants: Patients in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) who underwent ophthalmic surgeries were included in this analysis.
Main outcome measure: Incidence of endophthalmitis during the first 30 days after surgery.
Methods: Pediatric and adult patients in the IRIS® Registry with a diagnosis of acute endophthalmitis within 30 days after surgery from 2016 through 2024.
Results: The study analyzed 17 457 881 procedures. Rates of endophthalmitis varied by procedure. Among adults, the highest incidence occurred after open-globe repair (0.94%; 1 case per 106 procedures). The incidence of endophthalmitis was 0.097% (1 case per 1031 procedures) after vitrectomy for retinal detachment, 0.1% for trabeculectomy (1 case per 1000 procedures), 0.075% for tube shunts (1 case per 1333 procedures), and 0.068% for scleral buckle surgery (1 case per 1459 procedures). The incidence after cataract surgery was 0.038% (1 case per 2652 procedures), 0.039% (1 case per 2551 procedures) after standalone minimally invasive glaucoma surgery, 0.02% (1 case per 5013 procedures) after goniotomy, and 0.011% for strabismus surgery (1 case per 9091 procedures). Among pediatric patients, the incidence of endophthalmitis after open-globe repair was 0.87% (1 case per 115 procedures). The incidence of endophthalmitis was 0.415% (1 case per 675 procedures) after scleral buckle surgery, 0.11% (1 case per 871 procedures) after cataract surgery, 0.084% (1 case per 1190 procedures) after vitrectomy for retinal detachment, and 0.0072% (1 case per 13 884 procedures) after strabismus surgery. The risk of endophthalmitis was significantly higher for pediatric vs. adult patients after cataract surgery (P = 0.014). Endophthalmitis rates after same-date cataract and glaucoma surgery vs. glaucoma surgery alone did not differ significantly.
Conclusions: Rates of endophthalmitis after ophthalmic surgical procedures are variable, with the highest incidence being open-globe repair. Minimally invasive glaucoma surgery procedures showed comparable infection rates as standard cataract surgery. A higher rate of infection after cataract surgery occurred in pediatric patients when compared with adults.