Risk of Acute and Chronic Endophthalmitis in Pediatric and Adult Patients Post-Cataract Surgery: A TriNetx Study

Document Type

Conference Proceeding

Publication Date

6-2025

Publication Title

Investigative Ophthalmology and Visual Science

Abstract

Purpose : Approximately 5 million cataract surgeries are performed annually in the United States but only around 1000 cases are performed on pediatric patients. Previous literature suggests a proportionally higher rate of post-operative endophthalmitis in pediatric cases (0.51%) compared to adults (0.04%) with poorer visual prognosis. Given the relative rarity of pediatric cataract surgery and low incidence of endophthalmitis, a large database sample may help elucidate differences in post-operative endophthalmitis rates in adult and pediatric cataract surgery.

Methods : A retrospective cohort study was conducted with TriNetX (Cambridge, MA, USA). Two cohorts were created: 1. pediatric patients who received cataract surgery and 2. adult patients who received cataract surgery. Both cohorts were evaluated for development of acute or chronic endophthalmitis in separate models using ICD-10 codes H44.0 and H44.1 within the same follow-up period. Pediatric patients were defined as less than 18 years old, and adults were defined as greater than 18 years old. Acute endophthalmitis was defined as diagnosis less than 6 weeks after surgery, and chronic endophthalmitis was defined as 6 weeks to 1 year after surgery. A Cox proportional hazards model was applied and hazard ratios (HR) with 95% confidence intervals (CI) were calculated.

Results : A total of 3,298 pediatric and 648,240 adult patients receiving cataract surgery met inclusion criteria for the analysis. Pediatric patients were significantly more likely to develop acute endophthalmitis (HR 3.47, CI 2.44-4.92, p< 0.0001) and chronic endophthalmitis (HR 4.56, CI 3.16-6.59, p< 0.0001) than adult patients.

Conclusions : Pediatric patients who received cataract surgery are significantly more likely to develop acute and chronic endophthalmitis compared to adults, thus agreeing with previous retrospective studies. Risk factors predisposing to acute and chronic infection should be explored further to identify preventable risk. Cataract surgeons should perform closer post-operative surveillance with pediatric cases to prevent incidence of endophthalmitis.

Volume

66

Issue

8

First Page

5059

Comments

Association for Research in Vision and Ophthalmology ARVO Annual Meeting, May 4-8, 2025, Salt Lake City, UT

Last Page

5059

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