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D. W. Parke, III, Harry W. Flynn, Jr.; Risk Factors for Endophthalmitis and Retinal Detachment with Retained Intraocular Foreign Bodies. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4967.
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To analyze the risk factors for traumatic endophthalmitis and rhegmatogenous retinal detachment (RD) in patients with retained intraocular foreign bodies (IOFB).
A retrospective, interventional, consecutive series was performed of all patients examined and treated at Bascom Palmer Eye Institute for retained traumatic IOFB between January 1999 and December 2008. Analysis included chart review of presenting and final visual outcome, mechanism of injury, initial management, surgical details, and postoperative course.
A total of 108 eyes with IOFBs were identified. Mean initial best corrected visual acuity was 20/600 (range 20/20 to NLP), and final best corrected acuity was 20/210 (range 20/20 to NLP)(p=0.04). Endophthalmitis occurred in 7 of 108 eyes (6.4%) at presentation, and risk was higher with an injury during yard work with vegetable matter exposure (p=0.003). All eyes with IOFBs involving the posterior segment received intravitreal antibiotics at time of initial management, and there were no cases of endophthalmitis after initial management. RD was identified in 6 of 108 eyes (5.5%) at presentation. Risk factors for RD were entry through Zone Three (p<0.001) and posterior segment IOFB (p=0.028). Postoperative RD occurred in 11 of 102 eyes (10.7%). Risk factors or postoperative RD were preoperative endophthalmitis (p=0.001), posterior segment IOFB (p=0.008), and retinal impact sites from the IOFB (p=0.028).
Rates of endophthalmitis and RD in eyes with IOFBs were comparable to other studies. Risk factors for endophthalmitis included vegetable matter-related injury and delayed time interval from injury to initial management. Risk factors for RD were Zone Three entry site, posterior segment IOFB, endophthalmitis, and presence of retinal impact sites. In the current study, intravitreal antibioticadministration at the time of initial management was associated with the absence of postoperative endophthalmitis.
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