Infectious Endophthalmitis With Retained Intraocular Foreign Bodies

Abstract

Purpose: : To determine the risk factors and prognostic indicators of infectious endophthalmitis in eyes with retained intraocular foreign body (IOFB).

Methods: : 315 eyes with intraocular foreign bodies were reviewed for signs of infectious endophthalmitis between August 1996 and April 2005. Follow–up ranged from 1 to 85 months.

Results: : Thirty–seven eyes (11.7 %) with intraocular foreign bodies had evidence of infectious endophthalmitis, and thirty–one (83.8 %) of those eyes had signs of infection at the time of removal of the intraocular foreign body. The majority of eyes with an intraocular foreign body with or without endophthalmitis were in patients between 20 and 49 years of age. Endophthalmitis was more likely to develop in patients with occupational injury (P < 0.001). Infectious endophthalmitis was much less likely to develop in eyes with primary repair within 24 hours of the injury than in eyes with primary repair more than 24 hours after the injury (P < 0.01). Posterior segment foreign bodies was more like to develop endophthalmitis ( P<0.01). Positive culture was noted 15 patients (40.5%), and mixed infection were found in three patients. Visual prognosis was reasonably good with 12 (32.4 %) of 37 eyes attaining a visual acuity of 20/200 or better.

Conclusions: : Removal of a retained intraocular foreign body within 24 hours of injury markedly reduces the risk of infectious endophthalmitis developing. Mixed infection, poor initial visual acuity, and retinal detachment were the factors that played a significant role in determining the visual outcome.

Keywords: endophthalmitis