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PracticeUpdateEarly Endophthalmitis Incidence and Risk Factors Following Glaucoma Surgery in the Medicare Population From 2016 to 2019

Unveiling the Risks: Endophthalmitis Incidence Post-Glaucoma Surgery

In a comprehensive retrospective study, researchers delve into the incidence and risk factors of endophthalmitis following glaucoma surgeries among Medicare beneficiaries in the United States. The study provides critical insights into the postoperative risks associated with different types of glaucoma surgeries.

HCN Medical Memo
Physicians should be vigilant about the elevated risk of endophthalmitis post-glaucoma surgery, particularly for patients undergoing tube shunt procedures. Tailoring postoperative care based on identified risk factors, such as age and comorbidities, can mitigate these risks.

Study Design
  • Design: Retrospective, longitudinal study
  • Participants: Medicare Fee-For-Service and Medicare Advantage beneficiaries in the US, aged 65 years or older
  • Methods: Data from 2016 to 2019 was analyzed, identifying endophthalmitis cases within 42 days post-surgery using ICD-10 CM codes
  • Total Surgeries: 466,928 glaucoma surgeries, 310,823 (66.6%) combined with cataract surgery

“Given that the major risk factors for endophthalmitis identified in this study were increasing age, medical comorbidity, and male gender, this paper presents little that surgeons can modify, except for the recommendations regarding the timing of performing bilateral MIGS. Clearly, more research is needed on this topic.”
– Joseph W. Sassani, MD

Key Findings:
  • Incidence Rates: Endophthalmitis incidence was 1.5 per thousand for glaucoma surgeries, 1.1 for combined, and 0.8 for cataract surgeries alone
  • Diagnosis Timing: Median day of diagnosis was 16.5 days for glaucoma surgeries, compared to 8 and 6 days for combined and cataract surgeries
  • Risk Factors: Tube shunts and Charlson comorbidity index were significant risk factors; age and male gender were risk factors only for combined surgeries

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