[Endophthalmitis after cataract surgery: epidemiology, clinical features and antibiotic prophylaxis]. / Endoftalmitis tras cirugía de cataratas: epidemiología, aspectos clínicos y profilaxis antibiótica.

PURPOSE: To estimate the incidence of endophthalmitis after cataract surgery and to describe the main epidemiological and clinical data, as well as the role of intracameral antibiotics. METHODS: A cross-sectional descriptive study was conducted on patients who underwent cataract surgery in a public hospital over an 11-year period. An ocular infection database was used to report endophthalmitis occurrences and to collect the clinical features. Qualitative variables are described with their frequency distribution and qualitative variables, with the mean and the standard deviation. RESULTS: From January 1999 to December 2009, 15.173 patients underwent cataract surgery. A total of 43 patients suffered from postoperative endophthalmitis, giving an overall infection rate of 0.28% (95% CI: 0.20-0.36%). Among the 43 cases, there were 19 men and 24 women with a mean age of 78.5. Other clinical parameters evaluated were as follows: 25.58% were diabetic, 44.18% had some degree of immunosuppression and there were complications with posterior capsular tears in 18.6%. As regards antibiotic prophylaxis, 2 groups were considered: the first one did not receive intracameral antibiotic (8,099 patients) and the second group received intracameral cefuroxime (7,074 patients). There were 39 endophthalmitis in the first group with an infection incidence of 0.48% and 4 endophthalmitis in the second group with an infection incidence of 0.056%. The relative risk (RR) after-before cefuroxime was 0.12 (0.04-0.33) with P<0.05. CONCLUSIONS: The incidence of endophthalmitis after cataract surgery in an 11-year period was lower than 0.3%. Almost half of the patients had a higher systemic risk. Intracameral cefuroxime resulted in nearly a 9-fold reduction in the rate of infection.

Endoftalmitis tras cirugía de cataratas: epidemiología, aspectos clínicos y profilaxis antibiótica / Endophthalmitis after cataract surgery: epidemiology, clinical features and antibiotic prophylaxis

Objetivo: Estimar la incidencia de endoftalmitis tras cirugía de cataratas, la clínica y el papelde los antibióticos intracamerales.Métodos: Se realizó un estudio descriptivo transversal en pacientes operados de cataratas enun hospital público durante 11 años. Se diseñó una base de datos de infecciones ocularespara analizar los aspectos clínico-quirúrgicos. Las variables cualitativas se describen con sudistribución de frecuencias y las cuantitativas con la media y la desviación estándar.Resultados: Desde enero de 1999 hasta diciembre de 2009, 15.173 pacientes se operaron decataratas. Hubo 43 endoftalmitis postquirúrgicas con una incidencia global de 0,28% (IC95%: 0,20-0,36%). Había 19 varones y 24 mujeres, con una edad media de 78,5 an˜ os. Se evaluarondistintos parámetros clínicos: un 25,58% eran diabéticos, un 44,18% tenían algúngrado de inmunosupresión y hubo complicaciones con vitreorragia en el 18,6%. En cuanto aprofilaxis antibiótica, se consideraron 2 grupos: el primer grupo no recibió antibiótico intracameral(8.099 pacientes) y el segundo grupo sí recibió cefuroxima (7.074 pacientes). De las43 endoftalmitis, 39 pertenecieron al primer grupo y 4 al segundo, con lo que la incidenciade infección fue de 0,48% en el primer grupo y 0,056% en el segundo. El riesgo relativo (RR)tras la evaluación después-antes de cefuroxima fue de 0,12 (0,04-0,33) con una p < 0,05.Conclusiones: La incidencia de endoftalmitis tras cirugía de cataratas en 11 años fue inferioral 0,3%. Casi la mitad de los pacientes tenían un riesgo sistémico mayor. Con la cefuroximaintracameral la tasa de infección se redujo casi nueve veces más(AU)

Purpose: To estimate the incidence of endophthalmitis after cataract surgery and to describe the main epidemiological and clinical data, as well as the role of intracameral antibiotics. Methods: A cross-sectional descriptive study was conducted on patients who underwentcataract surgery in a public hospital over an 11-year period. An ocular infection databasewasused to report endophthalmitis occurrences and to collect the clinical features. Qualitativevariables are described with their frequency distribution and qualitative variables, with themean and the standard deviation.Results: From January 1999 to December 2009, 15.173 patients underwent cataract surgery. Atotal of 43 patients suffered from postoperative endophthalmitis, giving an overall infectionrate of 0.28% (95% CI: 0.20-0.36%). Among the 43 cases, there were 19 men and 24 womenwith a mean age of 78.5. Other clinical parameters evaluated were as follows: 25.58% werediabetic, 44.18% had some degree of immunosuppression and there were complicationswith posterior capsular tears in 18.6%. As regards antibiotic prophylaxis, 2 groups were considered:the first one did not receive intracameral antibiotic (8,099 patients) and the secondgroup received intracameral cefuroxime (7,074 patients). There were 39 endophthalmitis inthe first group with an infection incidence of 0.48% and 4 endophthalmitis in the secondgroup with an infection incidence of 0.056%. The relative risk (RR) after-before cefuroximewas 0.12 (0.04-0.33) with P < 0.05.Conclusions: The incidence of endophthalmitis after cataract surgery in an 11-year periodwas lower than 0.3%. Almost half of the patients had a higher systemic risk. Intracameralcefuroxime resulted in nearly a 9-fold reduction in the rate of infection(AU)

[Influence of visual function on quality of life in patients with glaucoma]. / Influencia de la función visual en la calidad de vida de los pacientes con glaucoma.

OBJECTIVE: To determine the relationship between visual function objective measures and the perceived quality of life in patients with glaucoma and ocular hypertension. METHOD: This was a cross-sectional study of quality of life. Patients required knowledge to understand the questionnaire. PERIOD OF STUDY: April-May 2006. SETTING: third level hospital in Madrid. INSTRUMENT: Visual Function Index (VF-14). Visual acuity, computerized perimetry and ophthalmological examination were all performed. RESULTS: 120 questionnaires were distributed, 89.1% were returned completed. Cronbach's alpha was used for data validity and reliability (0.88). 49 patients had ocular hypertension (HTO) and 71 had glaucoma (52.1% men and 47.9% women). The mean health status was 73.9 (SD 24.13; range: 0-100); HTO: 81.4 (SD: 16.3) and glaucoma: 68.69 (SD:22) (p=0.001). These results were significantly correlated with the quality of life and visual acuity (r=0.51), mean deviation (MD) r=0.35, education level (p=0.024), and sex (p=0.031). No significant differences were found in the older groups or for evolution time. CONCLUSIONS: Quality of life measures can be useful in the management of patients with glaucoma, as a moderate relationship was found between quality of life, visual acuity and visual field loss in such patients. The VF-14 seems to discriminate between glaucoma and ocular hypertensive patients.

Influencia de la función visual en la calidad de vida de los pacientes con glaucoma / Influence of visual function on quality of life in patients with glaucoma

Objetivo: Determinar la relación entre las medidas objetivas de la función visual y la percepción de los pacientes de su calidad de vida relacionada con la salud. Métodos: Estudio transversal de evaluación de la calidad de vida en pacientes con glaucoma o hipertensión ocular y con un nivel intelectual suficiente para comprender el cuestionario. Período de estudio: abril-mayo de 2006. Ambito: hospital de tercer nivel de la Comunidad de Madrid. Instrumento: Índice de Función Visual VF-14. Se registró agudeza visual, perimetría computerizada, y exploración oftalmológica completa. Resultados: Se recogieron 120 cuestionarios, en los que el 89,1% lo cumplimentó el propio paciente. Para el análisis de fiabilidad y validez de los datos se uso el índice de fiabilidad alpha de Cronbach (0,88). Cuarenta y nueve pacientes fueron diagnosticados de hipertensión ocular (HTO) y 71 de glaucoma (52,1% hombres y 47,9% mujeres). La valoración media de su calidad de vida fue de 73,9 (DE: 24,13 R: 0-100); HTO: 81,4 (DE: 16,3) y glaucoma 68,69 (DE: 22) (p=0,001). Se han encontrado diferencias del estado de salud en relación con la agudeza visual (r=0,51), defecto campimétrico (r=0,35), nivel de estudios (p=0,024), y sexo (p=0,031). No se observó peor estado de salud en los grupos de mayor edad ni con el tiempo de evolución de la enfermedad. Conclusiones: Las medidas de calidad de vida pueden resultar útiles en la monitorización de los pacientes con glaucoma. Observamos moderada correlación entre agudeza visual, alteración campimétrica y calidad de vida de los pacientes con glaucoma. El VF-14 permite diferenciar entre pacientes con glaucoma e hipertensión ocular

Objective: To determine the relationship between visual function objective measures and the perceived quality of life in patients with glaucoma and ocular hypertension. Method: This was a cross-sectional study of quality of life. Patients required knowledge to understand the questionnaire. Period of study: April-May 2006. Setting: third level hospital in Madrid. Instrument: Visual Function Index (VF-14). Visual acuity, computerized perimetry and ophthalmological examination were all performed. Results: 120 questionnaires were distributed, 89.1% were returned completed. Cronbach’s alpha was used for data validity and reliability (0.88). 49 patients had ocular hypertension (HTO) and 71 had glaucoma (52.1% men and 47.9% women). The mean health status was 73.9 (SD 24.13; range: 0-100); HTO: 81.4 (SD: 16.3) and glaucoma: 68.69 (SD:22) (p=0.001). These results were significantly correlated with the quality of life and visual acuity (r=0.51), mean deviation (MD) r=0.35, education level (p=0.024), and sex (p=0.031). No significant differences were found in the older groups or for evolution time. Conclusions: Quality of life measures can be useful in the management of patients with glaucoma, as a moderate relationship was found between quality of life, visual acuity and visual field loss in such patients. The VF-14 seems to discriminate between glaucoma and ocular hypertensive patients (Arch Soc Esp Oftalmol 2008; 83: 249-256)