Traumatic endophthalmitis following penetrating ocular injuries with retained intraocular foreign bodies

To evaluate the outcome and analyze the methods of surgical treatment of traumatic endophthalmitis following penetrating eye injuries with retained eye foreign bodies.

A total of 62 consecutive cases (58 men, 4 women) from January 1999 to December 2001 with IOFBs following penetrating eye injuries were retrospectively studied. The ages ranged from 8 to 46 years (mean 23 years). Sixty patients (63 eyes) underwent pars plana vitreotomy and 1 patient underwent external magnet extraction. The follow-up ranged from 3 to 36 months (mean 12.5 months).

Ten eyes developed endophthalmitis, among which 7 (10.94%) were diagnosed preoperatively. The most frequently cultured organism was Staphylococcus epidermis (44.44%, 4/9). Postoperatively, retinal detachment due to vitreoretinal proliferation occurred in 5 patients with endophthalmitis and in 9 patients without endophthalmitis. All the retinal detachments were reattached with additional vitreoretinal surgery. Two eyes with endophthalmitis and two without endophthalmitis were eviscerated.

Post-traumatic endophthalmitis with intraocular foreign bodies (IOFBs) deserves great attention because of its high incidence and poor prognosis. Vitrectomy is suggested for the treatment of IOFBs and its complications, and it should be performed as soon as possible. Routine intravenous administration of antibiotics combined with periocular injection and topical antibiotics postoperatively are recommended.