To compare the rate of postoperative endophthalmitis following immediately sequential bilateral cataract surgery (ISBCS) vs delayed sequential bilateral cataract surgery (DSBCS) using the American Academy of Ophthalmology IRIS® (Intelligent Research in Sight) Registry database.
Retrospective cohort study.
IRIS Registry patients who underwent cataract surgery during 2013-2018.
Patients who underwent cataract surgery were divided into two groups: (1) ISBCS and (2) DSBCS (second eye surgery ≥1 day following the first eye surgery) or unilateral surgery. Postoperative endophthalmitis was defined as endophthalmitis occurring within four weeks of surgery by International Classification of Diseases (ICD) code and ICD code with additional clinical criteria.
Rate of postoperative endophthalmitis.
Of 5,573,639 IRIS Registry patients who underwent cataract extraction, 165,609 had ISBCS and 5,408,030 had DSBCS or unilateral surgery (3,695,449 DSBCS, 1,712,590 unilateral surgery only). A total of 3,102 participants (0.056%) met study criteria of postoperative endophthalmitis with supporting clinical findings. The rates of endophthalmitis in either surgery eye between the two surgery groups were similar (0.059% in ISBCS group vs 0.056% in DSBCS or unilateral, P=0.53). Although the incidence of endophthalmitis was slightly higher in the ISBCS group compared to the DSBCS or unilateral group, the odds ratio (OR) did not reach statistical significance (1.08, 95% confidence interval: 0.87 – 1.31, P=0.47) after adjusting for age, sex, race, insurance status, and comorbid eye disease. Seven cases of bilateral endophthalmitis with supporting clinical data in the DSBCS group and no cases in the ISBCS group were identified.
Risk of postoperative endophthalmitis was not statistically significantly different between patients who underwent ISBCS and DSBCS or unilateral cataract surgery.

Copyright © 2021. Published by Elsevier Inc.