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Retained intraocular foreign bodies and endophthalmitis
W F Mieler1, M K Ellis, D F Williams
1Department of Ophthalmology, Medical College of Wisconsin, Milwaukee 53226.
Ophthalmology
|November 1, 1990
Summary
Prompt surgical removal of intraocular foreign bodies (IOFBs) and early treatment, including intravitreal antibiotics in high-risk cases, may prevent endophthalmitis. This study found no infections in 27 treated patients, even with positive cultures.
Area of Science:
- Ophthalmology
- Infectious Disease
Background:
- Retained intraocular foreign bodies (IOFBs) can lead to endophthalmitis in 7-13% of cases.
- The effectiveness of prompt surgical removal and intravitreal antibiotics in preventing endophthalmitis is not fully established.
Purpose of the Study:
- To evaluate the outcomes of prompt surgical intervention for retained IOFBs.
- To assess the incidence of endophthalmitis following surgical removal of IOFBs, with or without intravitreal antibiotics.
Main Methods:
- Retrospective review of 27 patients with retained IOFBs treated surgically between July 1986 and June 1989.
- Surgical removal of IOFBs, including pars plana vitrectomy in positive culture cases.
- Administration of subconjunctival, topical, systemic, and in some cases, intravitreal antibiotics.
Main Results:
- None of the 27 patients developed clinical signs of endophthalmitis.
- Bacterial cultures were positive in 7 cases, but no infections occurred.
- All eyes maintained excellent visual acuity (≥20/70) at an average 10-month follow-up.
Conclusions:
- Prompt surgical intervention for IOFBs appears to prevent endophthalmitis.
- Intravitreal antibiotics may be beneficial in high-risk cases.
- Pars plana vitrectomy and comprehensive antibiotic use contribute to favorable outcomes.