Post-Cataract Surgery Endophthalmitis is More Common in Kids than Adults

Ophthalmic surgery in the pediatric population warrants additional vigilance and family education, given the higher rates of postoperative infection. This age group may be especially vulnerable due to anatomical differences, increased surgical complexity and postoperative care challenges such as medication adherence. Photo: Joseph Sowka, OD. Click image to enlarge. Though rare, endophthalmitis after eye surgery can lead to irreversible damage and vision loss. Infection risk is influenced by many different factors from wound size and ocular comorbidities to the patient’s age and the surgical indication. Understanding which procedures present a higher risk for this potentially debilitating infection can guide perioperative care and patient counseling. To characterize endophthalmitis rates, researchers turned to the IRIS Registry. Their findings, published recently in Ophthalmology, are summarized below.The retrospective clinical cohort study included more than 17.4 million adults and children with an acute endophthalmitis diagnosis 30 days after surgery.The researchers reported that endophthalmitis rates varied by procedure (see table), with the highest incidences occurring after open globe repair in adults and children (0.94% and 0.87%, respectively). They also found that endophthalmitis risk was significantly higher in kids than in adults following cataract surgery. Infection rates after same-day cataract-glaucoma surgery vs. glaucoma surgery alone were similar.Reported Endophthalmitis Rates by ProcedureProcedureIncidence in AdultsIncidence in ChildrenOpen globe repair0.94%0.87%Vitrectomy for RD0.097%0.084%Trabeculectomy0.1% Tube shunts0.075% Scleral buckle surgery0.068%0.415%Cataract surgery0.038%0.11%Standalone MIGS0.039% Goniotomy0.02% Strabismus surgery0.011%0.0072% Given the differences in infection incidence between adults and children, these findings underscore “the risks involved with surgery in [the pediatric] population,” the researchers concluded.Click here for the journal source. Chaaya C, Goldberg EA, Ross CJ, et al. Comparative endophthalmitis rates in adult and pediatric patients across various ophthalmic practices: an IRIS Registry analysis. Ophthalmol 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.