OBJECTIVE To explore the risk factors for postoperative infectious endophthalmitis, distribution of pathogens and peripheral blood interleukin-17 (IL-17), matrix metalloproteinase-2 (MMP-2) and insulin-like growth factor-1 (IGF-1) in the patients with cataract and analyze the significance.

METHODS A total of 60, 000 patients with cataract who received surgical procedures in Daqing Eye Hospital from Jan. 2018 to Jun. 2024 were recruited as the research subjects. The aqueous humor and vitreous humor were collected from the patients with postoperative infectious endophthalmitis, and the isolated pathogens were identified. The baseline data were compared, the risk factors for the infectious endophthalmitis were analyzed. The levels of serum IL-17, MMP-2 and IGF-1 were compared, and the efficiencies of the indexes in prediction of infectious endophthalmitis were analyzed.

RESULTS Totally 65, 600 eyes involving 60, 000 patients were enrolled in the study, 21 of which (21 patients) were diagnosed with infectious endophthalmitis, with the incidence rate 0.032%. All of the 21 eyes were cultured positive for pathogens, among which gram-positive bacteria (73.08%) were dominant. Univariate analysis and multivariate analysis showed that complication with diabetes mellitus and vitreous overflow were the risk factors for the postoperative infectious endophthalmitis in the cataract patients. There were significant differences in the levels of serum IL-7, MMP-2 and IGF-1 between the infection group and the non-infection group after the surgery for 3 days(P < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the levels of serum IL-17, MMP-2 and IGF-1 after the surgery for 3 days could predict the occurrence of postoperative infectious endophthalmitis in the cataract patients, and the joint detection of the three indexes has highest predictive efficiency(P < 0.05), the area under the curve was 0.950, with the sensitivity 95.24%, the specificity 81.91%.

CONCLUSIONS The incidence rate of postoperative endophthalmitis is 0.032% among the cataract patients. The complication with diabetes mellitus and vitreous outflow are the risk factors. The gram-positive bacteria are dominant among the pathogens. The changes of serum IL-17, MMP-2 and IGF-1 levels are closely associated with the occurrence of endophthalmitis, which has predictive value.