Postoperative infection following strabismus surgery: case series and increased incidence in a single referral center

Robert J. House, Jill C. Rotruck, Laura B. Enyedi, David K. Wallace, Ezzeldin Saleh, Sharon F. Freedman

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: To identify and analyze cases of postoperative infection following strabismus surgery at a large referral center and to report the incidence, risk factors, and outcomes. Methods: An electronic database search identified strabismus procedures at Duke Eye Center from July 1996 to October 2017. Diagnosis codes for periocular infections were used to further identify patients with possible infections following strabismus surgery. Results: Of 9,111 strabismus surgeries, 13 (0.14%) met criteria for probable infection, all occurring since October 2012 (0/6580 before vs 13/2531 [0.51%] after; P < 0.0001). Mean age of infection cases was 11.4 years; 11 patients (85%) were under 18 years of age. Associated previous diagnoses were genetic abnormalities with associated developmental delay (n = 5 [38%]), previous skin or ear infection (n = 4 [31%]), and acute or chronic rhinitis (n = 3 [23%]). Infection site cultures revealed methicillin-resistant Staphylococcus aureus (n = 3 [23%]), methicillin-sensitive S. aureus (n = 3 [23%]), and Streptococcus pyogenes/group-A Streptococcus (n = 2 [15%]). Only 1 case had bilateral infection. Infection remained extraocular in all cases, but one eye lost light perception secondary to optic atrophy. No common surgeon/procedure/preparation-related risks were identified. Conclusions: A unifying explanation for the increase in post–strabismus surgery infections at Duke Eye Center was not identified. Potential risk factors include age <18 years, developmental delay, immune compromise, preceding nonocular infection, and bacterial colonization.

Original languageEnglish (US)
Pages (from-to)26.e1-26.e7
JournalJournal of AAPOS
Volume23
Issue number1
DOIs
StatePublished - Feb 1 2019

Fingerprint

Strabismus
Referral and Consultation
Incidence
Infection
Optic Atrophy
Methicillin
Streptococcus pyogenes
Rhinitis
Methicillin-Resistant Staphylococcus aureus
Streptococcus
Bacterial Infections
Ear
Staphylococcus aureus
Databases
Light
Skin

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Ophthalmology

Cite this

Postoperative infection following strabismus surgery : case series and increased incidence in a single referral center. / House, Robert J.; Rotruck, Jill C.; Enyedi, Laura B.; Wallace, David K.; Saleh, Ezzeldin; Freedman, Sharon F.

In: Journal of AAPOS, Vol. 23, No. 1, 01.02.2019, p. 26.e1-26.e7.

Research output: Contribution to journalArticle

House, Robert J. ; Rotruck, Jill C. ; Enyedi, Laura B. ; Wallace, David K. ; Saleh, Ezzeldin ; Freedman, Sharon F. / Postoperative infection following strabismus surgery : case series and increased incidence in a single referral center. In: Journal of AAPOS. 2019 ; Vol. 23, No. 1. pp. 26.e1-26.e7.
@article{52f82108300143869c5ab67fcc151c35,
title = "Postoperative infection following strabismus surgery: case series and increased incidence in a single referral center",
abstract = "Purpose: To identify and analyze cases of postoperative infection following strabismus surgery at a large referral center and to report the incidence, risk factors, and outcomes. Methods: An electronic database search identified strabismus procedures at Duke Eye Center from July 1996 to October 2017. Diagnosis codes for periocular infections were used to further identify patients with possible infections following strabismus surgery. Results: Of 9,111 strabismus surgeries, 13 (0.14{\%}) met criteria for probable infection, all occurring since October 2012 (0/6580 before vs 13/2531 [0.51{\%}] after; P < 0.0001). Mean age of infection cases was 11.4 years; 11 patients (85{\%}) were under 18 years of age. Associated previous diagnoses were genetic abnormalities with associated developmental delay (n = 5 [38{\%}]), previous skin or ear infection (n = 4 [31{\%}]), and acute or chronic rhinitis (n = 3 [23{\%}]). Infection site cultures revealed methicillin-resistant Staphylococcus aureus (n = 3 [23{\%}]), methicillin-sensitive S. aureus (n = 3 [23{\%}]), and Streptococcus pyogenes/group-A Streptococcus (n = 2 [15{\%}]). Only 1 case had bilateral infection. Infection remained extraocular in all cases, but one eye lost light perception secondary to optic atrophy. No common surgeon/procedure/preparation-related risks were identified. Conclusions: A unifying explanation for the increase in post–strabismus surgery infections at Duke Eye Center was not identified. Potential risk factors include age <18 years, developmental delay, immune compromise, preceding nonocular infection, and bacterial colonization.",
author = "House, {Robert J.} and Rotruck, {Jill C.} and Enyedi, {Laura B.} and Wallace, {David K.} and Ezzeldin Saleh and Freedman, {Sharon F.}",
year = "2019",
month = "2",
day = "1",
doi = "10.1016/j.jaapos.2018.09.007",
language = "English (US)",
volume = "23",
pages = "26.e1--26.e7",
journal = "Journal of AAPOS",
issn = "1091-8531",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - Postoperative infection following strabismus surgery

T2 - case series and increased incidence in a single referral center

AU - House, Robert J.

AU - Rotruck, Jill C.

AU - Enyedi, Laura B.

AU - Wallace, David K.

AU - Saleh, Ezzeldin

AU - Freedman, Sharon F.

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Purpose: To identify and analyze cases of postoperative infection following strabismus surgery at a large referral center and to report the incidence, risk factors, and outcomes. Methods: An electronic database search identified strabismus procedures at Duke Eye Center from July 1996 to October 2017. Diagnosis codes for periocular infections were used to further identify patients with possible infections following strabismus surgery. Results: Of 9,111 strabismus surgeries, 13 (0.14%) met criteria for probable infection, all occurring since October 2012 (0/6580 before vs 13/2531 [0.51%] after; P < 0.0001). Mean age of infection cases was 11.4 years; 11 patients (85%) were under 18 years of age. Associated previous diagnoses were genetic abnormalities with associated developmental delay (n = 5 [38%]), previous skin or ear infection (n = 4 [31%]), and acute or chronic rhinitis (n = 3 [23%]). Infection site cultures revealed methicillin-resistant Staphylococcus aureus (n = 3 [23%]), methicillin-sensitive S. aureus (n = 3 [23%]), and Streptococcus pyogenes/group-A Streptococcus (n = 2 [15%]). Only 1 case had bilateral infection. Infection remained extraocular in all cases, but one eye lost light perception secondary to optic atrophy. No common surgeon/procedure/preparation-related risks were identified. Conclusions: A unifying explanation for the increase in post–strabismus surgery infections at Duke Eye Center was not identified. Potential risk factors include age <18 years, developmental delay, immune compromise, preceding nonocular infection, and bacterial colonization.

AB - Purpose: To identify and analyze cases of postoperative infection following strabismus surgery at a large referral center and to report the incidence, risk factors, and outcomes. Methods: An electronic database search identified strabismus procedures at Duke Eye Center from July 1996 to October 2017. Diagnosis codes for periocular infections were used to further identify patients with possible infections following strabismus surgery. Results: Of 9,111 strabismus surgeries, 13 (0.14%) met criteria for probable infection, all occurring since October 2012 (0/6580 before vs 13/2531 [0.51%] after; P < 0.0001). Mean age of infection cases was 11.4 years; 11 patients (85%) were under 18 years of age. Associated previous diagnoses were genetic abnormalities with associated developmental delay (n = 5 [38%]), previous skin or ear infection (n = 4 [31%]), and acute or chronic rhinitis (n = 3 [23%]). Infection site cultures revealed methicillin-resistant Staphylococcus aureus (n = 3 [23%]), methicillin-sensitive S. aureus (n = 3 [23%]), and Streptococcus pyogenes/group-A Streptococcus (n = 2 [15%]). Only 1 case had bilateral infection. Infection remained extraocular in all cases, but one eye lost light perception secondary to optic atrophy. No common surgeon/procedure/preparation-related risks were identified. Conclusions: A unifying explanation for the increase in post–strabismus surgery infections at Duke Eye Center was not identified. Potential risk factors include age <18 years, developmental delay, immune compromise, preceding nonocular infection, and bacterial colonization.

UR - http://www.scopus.com/inward/record.url?scp=85061269910&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061269910&partnerID=8YFLogxK

U2 - 10.1016/j.jaapos.2018.09.007

DO - 10.1016/j.jaapos.2018.09.007

M3 - Article

C2 - 30611002

AN - SCOPUS:85061269910

VL - 23

SP - 26.e1-26.e7

JO - Journal of AAPOS

JF - Journal of AAPOS

SN - 1091-8531

IS - 1

ER -