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Published by: timoti on Jul 28, 2013
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ABSTRACTPurpose:
To trace the outbreak of postoperative Cataract Endophthalmitisand potentialfactors toendophthalmitis occurance.
Design:
Retrospective observationalcase series study.
Methods:
Postoperativecataract endophthalmitis cases during the period of April2005 to April2006 were enrolled in this study. Diagnosisof acute endophthalmitis was made clinically. Management followed the standard procedure of the hospital.Vitreous sample for bacteriologicalexamination were taken from vitrectomy or aquous tap.
Results:
 Atotalof 131cataract surgery were done and acute endophthalmitis was determined on 26 cases (19.8%) with onset period 1-7 days. Blindness wasfound on 19 case. Staphylococcus, enterobacter and pseudomonas were confirmed in 6patients. The atmosphere outside the operating room contains bacterialcolonies.
Conclusions:
 
The findingsuggested that high incidence of acute postoperative cataract endophthalmitis(19.8 %) may be related tomicrobialinfection asone of important potentialfactor. Despite severalroutes of antibiotic were used visualoutcome remains poor.
Keywords:
 
Postoperative endophthalmitis, Cataract
Correspondence:
Rukiah Syawal, c/o: Bag./SMF Ilmu Penyakit Mata Fakultas Kedokteran Universitas
4
assessed prospectively. The purpose of this study
INTRODUCTION
was to trace the possibilitiesof potentialfactor, andPostoperative cataract endophthalmitis is athe visual outcome of the outbreak acuteseriousand potentiallyblinding complication. Thepostoperative cataract endophthalmitis in Generalincidence after extracapsular cataract extraction and
1
HospitalDr. Wahidin Sudirohusodo, Makassar.phacoemulsification is0.04 % to 0.13 %. and tend toincrease over the last decade. The management withmodern antibiotic not improve visualout come and
METHODS
2,3
Thisstudywas a retrospective observationalseemsto remain poor.case-series, conducted at Department of   Manyfactors for endophthalmitis followingOphthalmologyDr. Wahidin Sudirohusodo Generalcataract surgery were investigated in the EuropeanHospitalMakassar during the period of April2005 toSociety of Cataract And Refractive Surgery (ESCRS) April2006.SurgerieswereeitherPhacoemulsificationmulti-centre study, out allthese factors are being
ISSN. 1693-2587
JOI
Jurnal Oftalmologi Indonesia
JurnalOftalmologiIndonesia Vol. 5, No. 2, Agustus 2007 : Hal. 137 - 140(Phaco), Extracapsular Cataract Extraction (ECCE) *No cataract surgerywere done evaluation andor SmallIncision Cataract Surgery (SICS). Allof the renovation the operating room.procedure were done by senior ophthalmic surgeon.The operating-room staff, surgical equipment, Identified microorganisme was found in 6 cases,generalaseptic protocolare uniform for allthe consisted of 2 staphylococcal epidermidis, 2surgeon. Povidone-iodine solution was used to Pseudomonas aerugynosa, one Enterobacter andprepare the lids, lashesand conjunctiva before one staphylococcus aureus.surgery. At the end of surgery combined Dibekacinand Dexamethasone were given suconjunctivally
Table2.
Characteristicof Endophthalmitis Casesfollowwith topicalantibiotic-steroid eye drop.Diagnosis of acute endophthalmitis was madeclinically, and the treatment followed the procedure of   thehospitaladoptedfromEndophthalmitisVitrectomyStudy(EVS), sample for bacteriologicalexaminationwere taken from vitrectomy or aqueous tap.Visualacuitywas recorded at the time of   admission or when diagnosis of endophthalmitis wassuspected. Visualoutcome wasdetermined after  endophthalmitistreatment and the patient dischargefrom the admission.
RESULTS
From April2005 to April2006, a totalof 131cataract surgery were done. Diagnosis postoperativecataract endophthalmitis was determined on 26cases (19.8 %) as shown in table 1.Charasteristic of endophthalmitis cases wasshown in table 2. Demographic of the patients shownthat male more than female, onzet period mostly less
Table3.
Visualoutcome after discharge fromthan 2 days and phaco procedure is common.
Table1.
Endophthalmitis cases from April2005 to April2006treatmentVisualoutcome in table 3 showed that blindnesswas found in 19 cases (73.0 %), only 4 cases hadvisualacuity more than 3/60. Three cases werereferred to the other top refferaleye centre.
DISCUSSION
The incidence of postoperative cataractendophthalmitis has been reported variability
1
between 0.04 % and 0.13 %. In Europe 0.12 %, USA
2,4,5
0.072 %, Australia 0.18 %, and Singapore 0.08 %.
JOI
138
JurnalOftalmologiIndonesia Vol. ,5No. 2, Agustus2007
THEOUTBREAK OFACUTEPOSTOPERATIVECATARACTENDOPHTHALMITIS ATDr. WAHIDINSUDIROHUSODOGENERALHOSPITALMAKASSAR 
RukiahSyawal
Department Of Ophthalmology MedicalFaculty Hasanuddin University/Dr. Wahidin SudirohusodoGeneralHospitalMakassar  
Cataract
 April200510440Mei200533100June 200535411,4July 200529620,6 August 20054125September 20055120October 200533100Novemver 2005*---December 2005*---January 200616318,7February 2006900March 20067114,2 April20061000
TOTAL 131 26 19,8
Time of Surgery Surgery Endophthalmitis
n n %Demographic n %
 Age (Year) > 60< 60Gender : FemaleMaleOnzet time from Surgery (day)< 2 days> 2 daysSurgicalProcedureECCEPhacoSICS1661,51038,5726,91973,12076,9623,1830,81453,8415,4Identified623,1
 Visual Acuity n %
0 1/3001350> 1/300 - = 3/ 60623,07> 3/60415,38No report311,53
TheOutbreak AcutePostoperative

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