Postcataract acute endophthalmitis in France: National prospective survey

Abstract

To report results of the National French Observational Database for Endophthalmitis (Observatoire National Des Endophtalmies [ONDE]). Departments of ophthalmology at universities, general hospitals, and private clinics. In this multicenter national interventional case series, data were collected prospectively between March 1, 2003, and November 1, 2004, from French ophthalmologists who answered a standardized 175-item questionnaire. The data were from patients with acute-onset endophthalmitis after cataract surgery. Before surgery, all 105 patients had received an official information card from the French Ophthalmological Society and provided written informed consent. The study comprised 105 patients. The median time from cataract extraction to endophthalmitis was 4 days (range 1 to 39 days). All but 1 patient had symptoms, with blurred vision being the most common. Initial visual acuity was 5/200 or better in 18.9% (18/95) of patients. Intraocular samples from 90.5% (95/105) of patients yielded 45 pathogens, of which 86.7% were gram positive. Treatments included intraocular antibiotic injections in 95.1% (98/103) of patients, intraocular steroid injections in 41.4% (41/99) of patients, and immediate vitrectomy in 14.0% (14/100) of patients. Visual acuity at 3 months was 20/100 in 64% of patients. The ONDE study disclosed important changes in French ophthalmic surgical practice 15 years after the first prospective endophthalmitis survey and 12 years after a United States study were published. Progress toward standardization of preventive methods (eg, patient information, increased systemic antibiotic efficacy, more frequent corticosteroid use) has contributed to fewer vitrectomies.