백내장수술 후 발생한 급성 안내염의 발생률과 위험인자 분석

Incidence and Risk factors of Acute Postoperative Endophthalmitis after Cataract Surgery in Korea

Purpose: To evaluate the incidence and risk factors of acute postoperative endophthalmitis (POE) after cataract surgery from 2011 to 2015 in Korea. Methods: A nationwide retrospective cohort study was performed by using claims data from the Korean National Health Insurance Service (KNHIS) database collected during 2011 to 2015. Cataract surgery and acute POE were identified using Korean Electronic Data Interchange (KEDI) code and Korean Classification of Disease (KCD)-7 code. Results: A total of 2,236,107 eyes in 1,591,176 patients (60.16% female; mean age 69.37 ± 10.07 years) underwent cataract surgery from 2011 to 2015 in Korea. The incidence of acute POE after cataract surgery was 0.09% and remained stable during 5 years period as the unadjusted incidence rate ratio (IRR) was 1.025 (95% confidence interval 0.988-1.064; p = 0.1932). A total of 2,041 eyes experienced acute POE (51.23% female; mean age 67.84 ± 11.99 years) after 8.46 ± 10.18 days after the cataract surgery. In multivariate analysis, intraoperative posterior capsule rupture, male gender and preoperative diabetes were associated with a higher risk of acute POE: 5.643 (4.454-7.148, p < 0.001), 1.408 (1.283-1.544, p < 0.001), 1.241 (1.125-1.371, p = 0.0167), respectively. Living in rural area, low household income and surgery in tertiary healthcare centers were socioeconomic factors significantly associated with higher risk of acute POE. Conclusions: The incidence of acute POE after cataract surgery in Korea remained unchanged during 5-year study period. Intraoperative posterior capsule rupture, male, preoperative diabetes, low household income and surgery in tertiary healthcare centers were associated with higher risk.