Intravitreal antibiotics may benefit some open-globe injuries

SAN FRANCISCO — Intravitreal antibiotics may reduce the risk of postsurgical endophthalmitis after foreign body open-globe ocular trauma, according to a speaker here.

Incidence of endophthalmitis following open-globe injury is about 10%, but certain subtypes may carry even greater risk, Demetrios Vavvas, MD, said during a presentation at Retina Subspecialty Day prior to the American Academy of Ophthalmology meeting.

"If we look at subtype, with intraocular foreign body, the incidence is about three times as much," Dr. Vavvas said.

In a review of 675 open globe injuries (95 foreign body), that occurred over a 7-year period, Dr. Vavvas and colleagues noted no difference in endophthalmitis according to time of presentation of injury or whether surgery was immediately performed or delayed.

Intravenous antibiotics were routinely used, especially if surgery had to be delayed, Dr. Vavvas said. Use of an IOL was predictive of endophthalmitis, albeit in a small sample size (1 of 6 with an IOL and 0 of 105 without; P = .05).

Intravitreal antibiotics were not used in the study population. However, a recent prospective, randomized study by Soheilian et al showed a protective effect in patients with foreign body injuries in 294 patients, Dr. Vavvas said.