Comparison of Post-cataract Surgery Endophthalmitis Rates Using Syringing or Regurgitation on Pressure over the Lacrimal Sac As a Preoperative Screening Tool for Nasolacrimal Duct Obstruction: An Impact Assessment of Protocol Alteration Due to The...

Overview

Journal Indian J Ophthalmol

Specialty Ophthalmology

Date 2021 Sep 28

PMID 34571642

Citations 4

Authors

Pratik Shenoy

Sonali Mehta

Chintan Shah

Rajesh Joshi

Pradhnya Sen

Narendra Patidar

Gaurav Mohan Kohli

Alok Sen

Affiliations

Soon will be listed here.

Abstract

Purpose: To compare the post-cataract endophthalmitis (PCE) rates among eyes undergoing syringing or regurgitation on pressure over the lacrimal sac (ROPLAS) test prior to cataract surgery.

Methods: We performed a single-center, retrospective, comparative analysis of eyes developing PCE who underwent syringing prior to cataract surgery (group A) in the pre-COVID-19 era between November 1 2019 and January 31, 2020 and the eyes that underwent ROPLAS test prior to cataract surgery (group B) in the COVID-19 era between November 1, 2020 and January 31, 2021.

Results: A total of 87,144 eyes underwent cataract surgery during the two time periods of the study. Syringing was performed in 48,071 eyes, whereas ROPLAS was performed in 39,073 eyes. In group A, 19 eyes (0.039%) developed PCE, whereas 20 eyes (0.051%) developed PCE in group B (P = 0.517). Between the two groups, the grade of anterior chamber cellular reaction (P = 0.675), hypopyon (P = 0.738), and vitreous haze (P = 0.664) were comparable. Gram-positive organisms were detected in 4 eyes in group A and 6 eyes in group B; 2 eyes in group A had gram-negative bacilli. The presenting visual acuity (Group A: LogMAR 1.42 and Group B: LogMAR 1.30) and final visual acuity (Group A: LogMAR 0.52 and Group B: LogMAR 0.5) were comparable between the two groups. (P = 0.544 and 0.384, respectively).

Conclusion: The rates of PCE were comparable among the eyes undergoing either syringing test or ROPLAS prior to cataract surgery.

Citing Articles

A comparative study of irrigation techniques and the development of a self-serve training model for ophthalmology residents.

Huang W, Li Z, Gao Y, Wang X, Lu M, Lin X BMC Med Educ. 2025; 25(1):344.

PMID: 40050882 PMC: 11884064. DOI: 10.1186/s12909-025-06889-2.

Lacrimal irrigation before intraocular surgery: Where are we today?.

Nair A Oman J Ophthalmol. 2024; 17(3):311-312.

PMID: 39651510 PMC: 11620315. DOI: 10.4103/ojo.ojo_334_24.

Syringing or ROPLAS before intraocular surgery: An ophthalmologist's dilemma.

Shrivastava P, Gangwe A, Chatterjee S, Mishra M, Agrawal D Indian J Ophthalmol. 2024; 72(12):1824-1825.

PMID: 39620682 PMC: 11727940. DOI: 10.4103/IJO.IJO_1217_24.

Diagnostic utility of tear meniscus height measurement using anterior segment optical coherence tomography for lacrimal passage disorder before cataract surgery.

Matsuyama H, Kadomoto S, Hosoda Y, Akimoto M Sci Rep. 2024; 14(1):25866.

PMID: 39468099 PMC: 11519514. DOI: 10.1038/s41598-024-75979-w.

Commentary: Rule out lacrimal duct obstruction before every intraocular procedure.

Singh M, Kaur M, Abhaypal K, Gupta P Indian J Ophthalmol. 2022; 70(11):3836-3837.

PMID: 36308106 PMC: 9907251. DOI: 10.4103/ijo.IJO_2228_22.

References

Jabs D, Nussenblatt R, Rosenbaum J . Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 2005; 140(3):509-16. PMC: 8935739. DOI: 10.1016/j.ajo.2005.03.057. View

Combey de Lambert A, Campolmi N, Cornut P, Aptel F, Creuzot-Garcher C, Chiquet C . Baseline factors predictive of visual prognosis in acute postoperative bacterial endophthalmitis in patients undergoing cataract surgery. JAMA Ophthalmol. 2013; 131(9):1159-66. DOI: 10.1001/jamaophthalmol.2013.4242. View

Shenoy P, Goh E, Kashikar R, Kohli G, Sachdeva M, Naman V . Impact of prophylactic intracameral moxifloxacin on post-cataract surgery endophthalmitis: data from a tertiary eye care facility in rural India. Int Ophthalmol. 2021; 41(8):2729-2736. DOI: 10.1007/s10792-021-01830-0. View

Hatch W, Cernat G, Wong D, Devenyi R, Bell C . Risk factors for acute endophthalmitis after cataract surgery: a population-based study. Ophthalmology. 2008; 116(3):425-30. DOI: 10.1016/j.ophtha.2008.09.039. View

Kam J, Cheng N, Sarossy M, Allen P, Brooks A . Nasolacrimal duct screening to minimize post-cataract surgery endophthalmitis. Clin Exp Ophthalmol. 2013; 42(5):447-51. DOI: 10.1111/ceo.12244. View

. Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Endophthalmitis Vitrectomy Study Group. Arch Ophthalmol. 1995; 113(12):1479-96. View

Sengupta S, Honavar S, Sachdev M, Sharma N, Kumar A, Ram J . All India Ophthalmological Society - Indian Journal of Ophthalmology consensus statement on preferred practices during the COVID-19 pandemic. Indian J Ophthalmol. 2020; 68(5):711-724. PMC: 7350466. DOI: 10.4103/ijo.IJO_871_20. View

Thomas R, Thomas S, Braganza A, Muliyil J . Evaluation of the role of syringing prior to cataract surgery. Indian J Ophthalmol. 1998; 45(4):211-4. View

Doft B, Wisniewski S, Kelsey S, Fitzgerald S . Diabetes and postoperative endophthalmitis in the endophthalmitis vitrectomy study. Arch Ophthalmol. 2001; 119(5):650-6. DOI: 10.1001/archopht.119.5.650. View

10.

Lopez P, Beldavs R, Al-Ghamdi S, Wilson L, Wojno T, Sternberg Jr P . Pneumococcal endophthalmitis associated with nasolacrimal obstruction. Am J Ophthalmol. 1993; 116(1):56-62. DOI: 10.1016/s0002-9394(14)71744-1. View

11.

Haripriya A, Chang D, Ravindran R . Endophthalmitis Reduction with Intracameral Moxifloxacin Prophylaxis: Analysis of 600 000 Surgeries. Ophthalmology. 2017; 124(6):768-775. DOI: 10.1016/j.ophtha.2017.01.026. View

12.

Nair A, Kamal S, Agarwal A . Indian survey on practice patterns of lacrimal & eyelid disorders (iSUPPLE): Report 3 - Cataract and nasolacrimal duct obstruction. Saudi J Ophthalmol. 2017; 31(3):145-149. PMC: 5569336. DOI: 10.1016/j.sjopt.2017.05.018. View