Clinical Findings Predicting Posttraumatic Endophthalmitis after Repair of Open Globe Injuries

Area of Science:

• Ophthalmology
• Trauma Surgery

Background:

• Open globe injuries pose a significant risk for endophthalmitis.
• Endophthalmitis following ocular trauma can lead to severe vision loss.

Purpose of the Study:

• To identify risk factors associated with developing endophthalmitis after open globe injury repair.
• To evaluate the effectiveness of prophylactic interventions in preventing posttraumatic endophthalmitis.

Main Methods:

• Retrospective chart analysis of 1303 patients undergoing open globe injury repair.
• Data collected from May 1996 to December 2019.
• Univariate analysis to identify significant predictors of endophthalmitis.

Main Results:

• Clinically suspected endophthalmitis occurred in 2.8% of eyes, with culture-proven cases in 1.1%.
• Significant predictors for suspected endophthalmitis included poor initial visual acuity, rural injury setting, contaminated wounds, and lens injury.
• Prophylactic intravitreal antibiotics at primary repair in high-risk eyes decreased endophthalmitis risk (OR: 2.28; 95% CI, 1.07-4.86; p = .033).

Conclusions:

• Poor initial visual acuity, rural injury settings, contaminated wounds, and lens injuries are associated with increased risk of posttraumatic endophthalmitis.
• Prophylactic intravitreal antibiotics administered during primary repair can mitigate the risk of endophthalmitis in high-risk eyes.