Risk of Traumatic Endophthalmitis With and Without Intravenous Antibiotic Prophylaxis

Abstract

Abstract: : Purpose: The goal of this study is to determine whether prophylactic intravenous antibiotics reduce the incidence of endophthalmitis following traumatic open globe injury. Methods: Retrospective chart review of 88 patients presenting with traumatic open globe injury. The mean age was 35.55 +/- 22.3 years (2 – 92) with 80.7% male and 19.3% female. Statistical analysis was performed using the chi-square test. Results: Visual acuity at presentation was > 20/400 in 18.9%, CF to HM in 29.7% and LP/NLP in 51.4%. Visual acuity at last follow-up was > 20/40 in 33.3% and LP/NLP in 35.8% with 25.9% requiring enucleation. Visual acuity at last follow-up was NLP in 16.1% in anterior globe injuries, NLP in 61.9% of posterior globe injuries, and > 20/40 in 69.2% of open globes with injury site < 5mm. The overall incidence of endophthalmitis was 3/88 (3.4%). Endophthalmitis incidence for patients receiving no intravenous antibiotics 2/45 (4.4%) was not statistically different from those receiving perioperative 1/41 (2.4%; Yates' chi-square, p=0.77) or postoperative antibiotics 1/14 (7.1%; Yates' chi-square, p=0.93). Conclusions: Intravenous antibiotics may not reduce the incidence of traumatic endophthalmitis. Postoperative inpatient care for traumatic open globe injuries may not be necessary.

Keywords: endophthalmitis • antibiotics/antifungals/antiparasitics