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Purpose To estimate the incidence of acute-onset endophthalmitis after cataract surgery and to report its clinical features, microbiology, and final visual outcomes. Setting King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Methods This was a retrospective observational case series. Results The 10-year incidence of acute-onset endophthalmitis after cataract surgery was 0.068%: 0.049% for extracapsular cataract extraction (ECCE) and 0.085% for clear corneal phacoemulsification (P = .268). The incidence of endophthalmitis was 0.053% during the first 5 years of the study and 0.08% during the next 5 years. The most common presenting features were pain and poor red reflex. Of the 20 cases, 18 were culture positive. The culture isolates showed Staphylococcus species in 7 eyes (35%), Streptococcus species in 7 eyes (35%), polymicrobial or mixed infections in 3 eyes (15%), and Propionibacterium acnes in 1 eye (5%). Two patients (10%) achieved a final visual acuity of 20/40 or better, 5 (25%) had worse than 20/40 to better than 20/200, and 8 (40%) had worse than 20/200; 5 eyes (25%) were eviscerated. Visual outcomes were good in endophthalmitis cases after phacoemulsification and in cases caused by Staphylococcus epidermidis and worse in cases that had Streptococcus species endophthalmitis. Conclusions Clear corneal phacoemulsification had a 1.73-fold higher risk for acute endophthalmitis than ECCE. Although the incidence of endophthalmitis after ECCE was lower than after phacoemulsification, the outcome was much worse in post-ECCE endophthalmitis cases. Poor visual outcomes were associated with more virulent organisms and delayed presentation.

Purpose To compare the visual outcomes and complications of laser in situ keratomileusis (LASIK) with those of surface treatment by laser-assisted subepithelial keratectomy (LASEK), photorefractive keratectomy with mechanical epithelial removal (M-PRK), and transepithelial photorefractive keratectomy (T-PRK). Setting Tertiary care eye center. Methods This retrospective review comprised all cases of LASIK, LASEK, M-PRK, and T-PRK performed at King Khaled Eye Specialist Hospital between July 1, 2004, and June 30, 2005. Separate statistical analyses were performed for eyes with low to moderate myopia (spherical equivalent [SE] less than −6.00 diopters [D]) and high myopia (SE −6.00 to −11.25 D). Results Of 696 eyes that met the inclusion criteria, 464 had LASIK, 104 had LASEK, 69 had M-PRK, and 59 had T-PRK. Eyes with low to moderate myopia had a statistically significantly smaller mean difference between logMAR final postoperative uncorrected visual acuity (UCVA) and preoperative best spectacle-corrected visual acuity (BSCVA) after T-PRK and M-PRK than after LASIK or LASEK. A higher percentage of eyes with high myopia had a final UCVA within ±2 lines of the preoperative BSCVA with T-PRK than with LASIK, LASEK, or M-PRK. There were more major non-flap–related complications after LASEK than after LASIK, M-PRK, or T-PRK. Conclusions In eyes with low to moderate myopia, T-PRK and M-PRK provided slightly better visual outcomes than LASIK or LASEK. In eyes with high myopia, T-PRK provided better visual outcomes than LASIK, LASEK, and M-PRK. Laser in situ keratomileusis was associated with the most major postoperative complications.