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POSTTRAUMATIC ENDOPHTHALMITIS: An 18-Year Case Series

Li, Xintong, MD; Zarbin, Marco, A., MD, PhD; Langer, Paul, D., MD; Bhagat, Neelakshi, MD

doi: 10.1097/IAE.0000000000001511
Original Study
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Purpose: To describe the demographics, characteristics, management, and visual outcomes of eyes diagnosed with endophthalmitis after open globe injury.

Methods: Retrospective cohort analysis of all patients diagnosed with endophthalmitis after open globe injury from 1997 to 2015 at University Hospital, Newark, NJ.

Results: Twenty-six eyes were identified (all male patients; mean age: 37 ± 15 years). Cultures were positive in 16 eyes (62%), with Staphylococcus species (7 eyes, 44%) being the most common organism. Twelve eyes (46%) presented with open globe injury and concurrent endophthalmitis; 14 eyes (54%) developed endophthalmitis a mean of 14 days after open globe repair (OGR; 1 outlier of 98 days excluded). All eyes were managed with systemic and intravitreal antibiotics. The presence of intraocular foreign body (P < 0.05) and delayed primary OGR (P < 0.03) were significantly more common with concurrent versus post-OGR endophthalmitis. Four (29%) eyes in the post-OGR endophthalmitis group had corneal wound leak after OGR. Four (15%) eyes with no light perception vision were enucleated. Ten (40%) of 25 eyes with documented best-corrected visual acuity had final best-corrected visual acuity ≥20/200; final best-corrected visual acuity ranged from no light perception to 20/20.

Conclusion: The presence of intraocular foreign body and delayed presentation were significantly more common with concurrent endophthalmitis. Twenty-nine percent of eyes that presented with endophthalmitis after OGR had a wound leak. Final best-corrected visual acuity ≥20/200 was achieved in 40% of cases.

Endophthalmitis after open globe injury is rare. The authors report a retrospective case series of 26 eyes with posttraumatic endophthalmitis: 12 presented with endophthalmitis concurrently with open globe injury and 14 developed it after primary globe repair. Aggressive prompt treatment salvaged the globe and some vision in less than half of cases.

Department of Ophthalmology, Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey.

Reprint requests: Neelakshi Bhagat, MD, Department of Ophthalmology, Doctors Office Center, Suite 6100, 90 Bergen Street, Newark, NJ 07103; e-mail: bhagatne@njms.rutgers.edu

Selections from this material have been presented at the Macula Society Annual Meeting in Fort Lauderdale, FL, February 26, 2016 and at the Association for Research in Vision and Ophthalmology Annual Meeting in Seattle, WA, May 3, 2016.

None of the authors has any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.