June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Endophthalmitis after open globe trauma
Author Affiliations & Notes
  • Sebastian Lesniak
    IOVS - New Jersey Medical School, Newark NJ, Newark, NJ
  • Alain Bauza
    IOVS - New Jersey Medical School, Newark NJ, Newark, NJ
  • Marco Zarbin
    IOVS - New Jersey Medical School, Newark NJ, Newark, NJ
  • Paul Langer
    IOVS - New Jersey Medical School, Newark NJ, Newark, NJ
  • Neelakshi Bhagat
    IOVS - New Jersey Medical School, Newark NJ, Newark, NJ
  • Footnotes
    Commercial Relationships Sebastian Lesniak, None; Alain Bauza, None; Marco Zarbin, Iridex (C), Novartis (C), Pfizer (C), Calhoun Vision (C), Imagen Biotech (C), UMDNJ (P); Paul Langer, None; Neelakshi Bhagat, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1121. doi:
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    • Get Citation

      Sebastian Lesniak, Alain Bauza, Marco Zarbin, Paul Langer, Neelakshi Bhagat; Endophthalmitis after open globe trauma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1121.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To evaluate the demographics, characteristics, and outcomes of endophthalmitis after open globe trauma.

 
Methods
 

Retrospective chart review of patients with endophthalmitis after open globe injuries that presented to University Hospital, Newark, between 2001-2010.

 
Results
 

Eighteen patients were identified who were diagnosed with endophthalmitis after open globe trauma between 2001-2010. Fifteen records were available for review. The average age of patients was 43.3 years (range, 8-87), and 93% were male. There were 12 accidental injuries, 2 wound dehiscences, and 1 violent assault. Eight injuries were classified as penetrations, 4 as intraocular foreign bodies (IOFB), 2 as ruptures, and 1 was unspecified. There were 10 zone 1 injuries, 4 zone 2, and 1 zone 3 injury. Retinal detachment was diagnosed in 6 cases (40%). Two patients (13.3%) were diagnosed with endophthalmitis on presentation. In 14 cases the mean duration from injury to diagnosis of endophthalmitis was 8.6 days (range 1-42 days). One patient presented with delayed onset, 6 months after open globe trauma. IOFB was diagnosed in 4 cases (26.7%), 3 were metallic and 1 was glass. Three of these 4 IOFB's were in the posterior chamber. Four eyes (26%) were enucleated. One patient (6.7%) came in with no-light-perception (NLP) vision and 4 patients (26.7%) ended up NLP. Seven patients (46.7%) underwent pars-plana vitrectomy (PPV) during the initial open globe surgery. Six patients (40%) underwent open globe repair, and subsequently required PPV due to development of endophthalmitis. In 1 case (6.7%) the initial penetrating wound self-sealed, but later required a PPV due to endophthalmitis. In 1 case (6.7%) the second surgery after open globe repair was enucleation. Fourteen cases (93.3%) underwent vitreous biopsy with culture, and were injected with intravitreal antibiotics. The remaining 1 case was enucleated after developing endophthalmitis. All cases received IV antibiotics. Vitreous cultures were negative in 5 cases (33.3%). There were 3 cases (20%) of S. epidermidis, and single cases of the following organisms: MRSA, MSSA, B. cereus, E. vulneris, S. hominis, Candida famata, and Gemella morbillorum. The average presenting visual acuity was 1.787 logMAR, and the average final corrected visual acuity was 1.556 logMAR.

 
Conclusions
 

Endophthalmitis after open globe trauma remains a serious complication often leading to poor visual outcome, with 26.7% of eyes ending up with NLP vision.

 
Keywords: 513 endophthalmitis • 688 retina • 742 trauma  
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