Purchase this article with an account.
Sebastian Lesniak, Alain Bauza, Marco Zarbin, Paul Langer, Neelakshi Bhagat; Endophthalmitis after open globe trauma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1121.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the demographics, characteristics, and outcomes of endophthalmitis after open globe trauma.
Retrospective chart review of patients with endophthalmitis after open globe injuries that presented to University Hospital, Newark, between 2001-2010.
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.
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.
This PDF is available to Subscribers Only