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Kowloon East Cluster service arrangement for cataract surgery
The following is issued on behalf of the Hospital Authority:

     The spokesperson for Kowloon East Cluster (KEC) made the following announcement today (March 8) regarding the service arrangement for cataract surgery:
     A 92-year-old male patient who underwent right eye cataract surgery at the KEC Cataract Centre located at Tseung Kwan O Hospital (TKOH) on March 1 was admitted to United Christian Hospital via the Accident and Emergency Department of TKOH on March 5 because of right eye pain and blurring of vision. With a clinical diagnosis of postoperative endophthalmitis, antibiotic treatment was given but the patient's condition continued to deteriorate. On March 7, urgent evisceration of the right eye was performed. The patient is still under hospitalisation with stable condition. His eye specimen obtained was tested positive for streptococcus pneumoniae. The hospital has explained to the patient's relatives about the case. Invasive pneumococcal disease is one of the statutorily notifiable infectious diseases, so the case was reported to the Centre for Health Protection according to the prevailing requirement. 
     Streptococcus pneumoniae is commonly found in the nose and throat of healthy people and the source of invasive streptococcus pneumoniae endophthalmitis after cataract surgery is mostly endogeneous. Literatures showed that 70 per cent of postoperative endophthalmitis secondary to streptococcus pneumoniae eventually required evisceration. It was noted two other patients developed postoperative endophthalmitis after undergoing cataract surgery in early 2017. Appropriate antibiotic treatment and follow-up were arranged for these two patients who have since fully recovered. Their eye specimen obtained were tested to bacteria culture negative.
     Preliminary investigation revealed that the workflow of the operating threatre complied with the prevailing guidelines, and no irregularities were observed in its facilities and environment. It is believed that the cases involved were not related to the operation theatre environment. Since the postoperative endophthalmitis rate is higher than the baseline (zero postoperative endophthalmitis case at KEC after cataract surgeries from 2010 to 2016) and the severe invasive streptococcus pneumoniae case is identified, as a precautionary measure to ensure patient safety, the Cataract Centre has suspended its service with effect from today (March 8) to March 13 to conduct thorough environmental cleansing, instrument culture and air sampling.
     The hospital has already contacted 50 affected patients for rescheduling of their non-emergency operation in the coming two months according to their clinical condition. Patients who underwent cataract surgeries since March 1 would also be contacted to explain the situation and put under close monitoring. Patients can call the enquiry hotline of the Cataract Centre at 2208 0248 during office hours if they feel unwell.
     The KEC has reported the case to the Hospital Authority Head Office via the Advance Incident Reporting System.
Ends/Wednesday, March 8, 2017
Issued at HKT 23:44
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