Infectious endophthalmitis after penetrating injuries with retained intraocular foreign bodies

J. T. Thompson, L. M. Parver, C. L. Enger, W. F. Mieler, P. E. Liggett

Research output: Contribution to journalArticle

Abstract

Purpose: To determine the risk factors and prognostic indicators of infectious endophthalmitis in eyes with penetrating injury and retained intraocular foreign body. Methods: From the National Eye Trauma System (NETS) Registry, 492 eyes with intraocular foreign bodies were reviewed for signs of infectious endophthalmitis. Results: Thirty-four eyes (6.9%) with intraocular foreign bodies had evidence of infectious endophthalmitis, and 31 (91.2%) 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 10 and 39 years of age, but the risk of endophthalmitis developing increased with age, especially in patients 50 years of age or older with delayed primary repair (P = 0.005). Endophthalmitis was more likely to develop in eyes with home or occupational injuries (33/358, 9.2%) than in those with injuries from other settings (1/128, 0.8%; P = 0.001). Infectious endophthalmitis was much less likely to develop in eyes with primary repair within 24 hours of the injury (10/287 = 3.5%) than in eyes with primary repair more than 24 hours after the injury (22/164, 13.4%; P <0.0001). Bacilli or staphylococci were isolated in 21 (95%) of 22 eyes with positive cultures. Visual prognosis was reasonably good with 15 (58%) of 26 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. Older persons are at high risk for endophthalmitis developing after retaining an intraocular foreign body when there is delayed surgical repair.

Original languageEnglish (US)
Pages (from-to)1468-1474
Number of pages7
JournalOphthalmology
Volume100
Issue number10
StatePublished - 1993
Externally publishedYes

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Endophthalmitis
Foreign Bodies
Wounds and Injuries
Penetrating Eye Injuries
Occupational Injuries
Staphylococcus
Bacillus
Visual Acuity
Registries

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Thompson, J. T., Parver, L. M., Enger, C. L., Mieler, W. F., & Liggett, P. E. (1993). Infectious endophthalmitis after penetrating injuries with retained intraocular foreign bodies. Ophthalmology, 100(10), 1468-1474.

Infectious endophthalmitis after penetrating injuries with retained intraocular foreign bodies. / Thompson, J. T.; Parver, L. M.; Enger, C. L.; Mieler, W. F.; Liggett, P. E.

In: Ophthalmology, Vol. 100, No. 10, 1993, p. 1468-1474.

Research output: Contribution to journalArticle

Thompson, JT, Parver, LM, Enger, CL, Mieler, WF & Liggett, PE 1993, 'Infectious endophthalmitis after penetrating injuries with retained intraocular foreign bodies', Ophthalmology, vol. 100, no. 10, pp. 1468-1474.
Thompson JT, Parver LM, Enger CL, Mieler WF, Liggett PE. Infectious endophthalmitis after penetrating injuries with retained intraocular foreign bodies. Ophthalmology. 1993;100(10):1468-1474.
Thompson, J. T. ; Parver, L. M. ; Enger, C. L. ; Mieler, W. F. ; Liggett, P. E. / Infectious endophthalmitis after penetrating injuries with retained intraocular foreign bodies. In: Ophthalmology. 1993 ; Vol. 100, No. 10. pp. 1468-1474.
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abstract = "Purpose: To determine the risk factors and prognostic indicators of infectious endophthalmitis in eyes with penetrating injury and retained intraocular foreign body. Methods: From the National Eye Trauma System (NETS) Registry, 492 eyes with intraocular foreign bodies were reviewed for signs of infectious endophthalmitis. Results: Thirty-four eyes (6.9{\%}) with intraocular foreign bodies had evidence of infectious endophthalmitis, and 31 (91.2{\%}) 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 10 and 39 years of age, but the risk of endophthalmitis developing increased with age, especially in patients 50 years of age or older with delayed primary repair (P = 0.005). Endophthalmitis was more likely to develop in eyes with home or occupational injuries (33/358, 9.2{\%}) than in those with injuries from other settings (1/128, 0.8{\%}; P = 0.001). Infectious endophthalmitis was much less likely to develop in eyes with primary repair within 24 hours of the injury (10/287 = 3.5{\%}) than in eyes with primary repair more than 24 hours after the injury (22/164, 13.4{\%}; P <0.0001). Bacilli or staphylococci were isolated in 21 (95{\%}) of 22 eyes with positive cultures. Visual prognosis was reasonably good with 15 (58{\%}) of 26 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. Older persons are at high risk for endophthalmitis developing after retaining an intraocular foreign body when there is delayed surgical repair.",
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