Baseline predictive factors of visual prognosis in acute bacterial postcataract endophthalmitis

Purpose To identify baseline clinical factors of visual prognosis in patients with acute endophthalmitis following cataract surgery. Methods 99 patients of four academic hospitals (FRIENDS group). Factors were analyzed based on the final visual outcome, defined as poor (<20/100) or good (≥20/40) using univariate and multivariate analysis Results Multiple logistic regression analysis showed that high bacterial virulence was the only independent factor (odds ratio [OR]= 14, 95% confidence interval [CI]: 2.7–71, p=0.001) for poor visual outcome. On the other hand, low bacterial virulence (OR=0.1 95%CI: 0.03–0.6, p=0.01) and the absence of complications (OR=0.07, 95%CI: 0.01–0.4, p=0.003) during cataract surgery were independent factors for good VA. Conclusion Visual outcome factors in acute postcataract endophthalmitis identified in this prospective study (2004–2007) were similar to those reported by the EVS 10 years ago. The bacterial virulence level was the main predictive factor of final visual prognosis. This emphasizes the need for rapid bacterial identification and characterization using new biomolecular tools.