Early closure of intraocular foreign body wounds reduces risk for endophthalmitis

Am J Ophthalmol. 2011;152(1):66-73

Self-sealing intraocular foreign body wounds and those repaired within 24 hours of injury were less likely to develop endophthalmitis, a study found.

Wounds that are larger than the foreign body, those located in the posterior segment and those with worse presenting visual acuity were more likely to be associated with endophthalmitis, the study authors said.

A retrospective, consecutive case series analyzed 1,421 eyes of 1,299 patients who presented with a retained intraocular foreign body. The study was conducted at 15 tertiary hospitals in China over a 5-year period. Patient histories and detailed information on the affected eyes were collected and analyzed. Male patients made up 93.1% of presenting cases, and 76.35% of the cases occurred on the job site.

Endophthalmitis occurred in 232 eyes (16.76%). The enucleation rate was 7.53%, and best corrected visual acuity improved in 54.33% of patients.

Wounds that were repaired within 24 hours of occurrence had a lower rate of developing endophthalmitis. Reduction of infection risk was statistically significant for early wound closure (P= .006) and self-sealing wounds (P = .013).

"We found that the [intraocular foreign body] characteristics such as size, location, material and even the timing of the [intraocular foreign body] removal were not related to the development of endophthalmitis, but that primary repair with 24 hours or self-sealing of wounds were significant protective factors," the authors said.