The Malaysian cataract surgery registry:incidence and risk factors of postoperative infectious endophthalmitis over a 7-year period

AIM：To report the incidence,risk factors and visual outcomes for postoperative endophthalmitis（POE）based on 7-year data from the Malaysian Ministry of Health Cataract Surgery Registry（MOH CSR）.METHODS：Data was collected from the web-based MOH CSR.All consecutive cataract surgery patients from 1st June 2008 to 31st December 2014 were identified.Exclusion criteria were traumatic cataract or previous ocular surgery.Demographic data,ocular co-morbidities,intraoperative details and postoperative visual acuity（VA）at final ophthalmological follow-up were noted.All eyes were taken for analysis.Subjects with POE were compared against subjects with no POE for risk factor assessment using multiple logistic regressions.RESULTS：A total of 163 503 subjects were screened.The incidence of POE was 0.08%（131/163 503）.Demographic POE risk factors included male gender（OR：2.121,95%CI：1.464-3.015）and renal disease（OR：2.867,95%CI：1.503-5.467）.POE risk increased with secondary causes of cataract（OR：3.562,95%CI：1.740-7.288）,uveitis（OR：11.663,95%CI：4.292-31.693）and diabetic retinopathy（OR：1.720,95%CI：1.078-2.744）.Intraoperative factors reducing POE were shorter surgical time（OR：2.114,95%CI：1.473-3.032）,topical or intracameral anaesthesia（OR：1.823,95%CI：1.278-2.602）,posterior chamber intraocular lens（PCIOL;OR：4.992,95%CI：2.689-9.266）and foldable IOL（OR：2.276,95%CI：1.498-3.457）.POE risk increased with posterior capsule rupture（OR：3.773,95%CI：1.915-7.432）and vitreous loss（OR：3.907,95%CI：1.720-8.873）.Postoperative VA of 6/12 or better was achieved in 15.27%（20/131）subjects with POE.CONCLUSION：This study concurs with other studies regarding POE risk factors.Further strengthening of MOH CSR data collection process will enable deeper analysis and optimization of POE treatment.

Wisdom Tooth Surgery Complications—Local Anaesthesia versus General Anaesthesia

Purpose: To compare the complication rates arising from surgical removal of lower third molars (L3M) under general anaesthesia (GA) versus local anaesthesia (LA) in the Oral and Maxillofacial Surgery (OMFS) Department, Hospital Sultanah Nora Ismail (HSNI), Batu Pahat, Johor, Malaysia. Materials and methods: This is a retrospective clinical audit of patients who underwent L3M removal under LA or GA from 1/1/2013 to 31/3/2018, with recorded complications such as surgical site infection (SSI), wound breakdown, severe pain, trismus, retained tooth structure, nerve injury and dry socket evaluated at different time intervals. Results: A total of 313 patients with 375 L3M were included in this study (male: 160, 51.1%;female: 153, 48.9%) with an age range of 18 to 40 years (mean = 27.43 years). 79 L3M were removed under GA (34.2% were classified as mild;65.8% were moderate), whereas 296 L3M were removed under LA, (31.4% were mild impaction, 63.9% moderate and 4.7% severe. Preoperative antibiotics were given before all L3M removal under GA, while only 23 out of 296 L3M removal under LA had antibiotics. 15.2% of L3M removal under GA and 16.6% of those done under LA were associated with complications. Generally, patient with GA had lesser complications;however only SSI outcome was significant (p = 0.034). Conclusion: L3M removal under LA may have a higher risk of SSI when compared to GA. This raises the possibility that a single prophylactic antibiotic dose may prevent SSI in LA procedures.

Erratum to “Wisdom Tooth Surgery Complications—Local Anaesthesia versus General Anaesthesia”, [Open Journal of Stomatology, 9 (2019) 51-63]

The original online version of this article (Hui Woon Lim (2019) Wisdom Tooth Surgery Complications-Local Anaesthesia versus General Anaesthesia. Volume 9, 51-63. doi:10.4236/ojst.2019.93006) needs some further amendments and clarification.