Design: Retrospective registry cohort
Population: 17,457,881 ophthalmic procedures in the IRIS Registry, 2016 to 2024
Primary outcome: Endophthalmitis within 30 days
Effect: Adult cataract 0.038%; open-globe repair 0.94%; paediatric cataract 0.11%

The American Academy of Ophthalmology IRIS Registry, published in April, analysed 17,457,881 procedures from 2016 to 2024 for acute endophthalmitis within 30 days.

In adults, open-globe repair had the highest rate (0.94%, about 1 in 106). Vitrectomy for detachment and trabeculectomy were about 1 in 1,000, tube shunts 1 in 1,333, cataract surgery 1 in 2,652, standalone MIGS 1 in 2,551 and strabismus surgery 1 in 9,091. In children, cataract surgery carried a higher rate than in adults (0.11%, about 1 in 871; p = 0.014), and scleral buckle 1 in 675. Combined cataract and glaucoma surgery did not raise the rate over glaucoma surgery alone.

These are useful consent numbers. Registry data may under-record cases treated elsewhere, so true rates may be slightly higher.

Use procedure-specific endophthalmitis figures when consenting.
Give prophylaxis and early review after open-globe repair, where the risk is highest.
Take extra care with asepsis and follow-up in paediatric cataract surgery.
Reassure patients that combining cataract with glaucoma surgery did not raise the rate.

Why it matters

It replaces rough estimates with registry-scale figures for each operation.

The statistics, in plain English

With millions of procedures, these rates are precise for US practice. They depend on correct coding in electronic records, and infections treated at another centre may be missed.