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ISSN 1561-3070 (Electronic)

2015, Number 4

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Rev Cub Oftal 2015; 28 (4)

Predictive factors related to the occurrence and visual prognosis of traumatic endophthalmitis

Perera ME, Rodríguez RV, Rúa MR, Suñet ÁM, Guerra GRA, García FL

Language: Spanish
References: 24
Page: 341-350
PDF size: 123.03 Kb.


ABSTRACT

Objective: to determine predictive factors related with the occurrence and the visual prognosis of traumatic endophthalmitis.
Methods: longitudinal case series study of 191 patients with severe open globe trauma conducted in two years. The patients answered a questionnaire, underwent complete physical ophthalmological exam and dynamic refraction, and if necessary, ocular ultrasound, x-and/or computed tomography scanning were applied.
Results: prevalence of traumatic endophthalmitis was 12,04 %. Mean age was 40,87 ± 14,25 (range of 16-70 year years). Males (95,65%) and the right eye (69,57%) predominated. The risk factor analysis related with traumatic endophthalmitis showed statistical significance for environment (p=0,052), presence of intraocular foreign body (p=0,069), rupture of the lens (p ‹ 0,0001), wound size (p ‹ 0,0001) and primary wound repair (p ‹ 0,0001). Twenty six percent of patients with spontaneous closing wounds were sutured. All the patients with spontaneous closing wounds, who developed endophthalmitis, were in the non-sutured group. Retinal detachment (p=0,059), wound size (p=0,058) and systemic antibiotic use (p=0,004) were statistically significant factors for the visual prognosis.
Conclusions: in the management of patients with ocular open globe trauma, it is essential to prevent traumatic endophthalmitis, with strict follow-up of the patient. It may be advisable to administer systemic antibiotic, and another important pillar will be the individualization of treatment through identifying the risk factors supporting the administration of an intravitreal antibiotic.


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