Durrani Asad F, Zhao Peter Y, Zhou Yunshu, Huvard Michael, Azzouz Lyna, Keil Jason M, Armenti Stephen T, Dedania Vaidehi S, Musch David C, Zacks David N
Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA.
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
Clin Ophthalmol. 2021 May 18;15:2077-2087. doi: 10.2147/OPTH.S307718. eCollection 2021.
BACKGROUND/AIMS: To determine the rate of endophthalmitis and assess risk factors for development of endophthalmitis following open globe injury (OGI).
A retrospective chart review of all patients treated for OGI at the University of Michigan from January 2000 to July 2017 was conducted. Exclusion criteria included intravitreal injection or intraocular surgery in the 30 days prior to injury or less than 30 days of follow-up. A total of 586 out of 993 open globe injuries were included in the study. The main outcome measure was the rate of endophthalmitis.
In this study, 25/586 eyes (4.3%) had endophthalmitis. Of these, 12/25 eyes (48.0%) presented with endophthalmitis and 13/25 eyes (52.0%) developed endophthalmitis after globe closure. Multivariate analysis identified time to globe repair (OR 4.5, CI 1.9-10.7, p = 0.0008), zone I injury (OR 3.6, CI 1.1-11.0, p = 0.0282), and need for additional surgery (OR 5.5, CI 1.5-19.7, p = 0.0092) as factors associated with increased risk of developing endophthalmitis. Subconjunctival antibiotic injection at the time of globe closure (OR 0.3, CI 0.1-0.7, p = 0.0036) was associated with decreased risk of developing endophthalmitis.
Prompt globe closure and subconjunctival antibiotics may reduce the risk of endophthalmitis in OGI. Furthermore, our practice of a one-time dose of systemic prophylactic antibiotics, and intravitreal antibiotics if intraocular foreign body (IOFB) removal is delayed, was not found to increase the rate of endophthalmitis.
背景/目的：确定眼内炎发生率，并评估开放性眼球损伤（OGI）后发生眼内炎的危险因素。
对2000年1月至2017年7月在密歇根大学接受OGI治疗的所有患者进行回顾性病历审查。排除标准包括受伤前30天内进行玻璃体内注射或眼内手术，或随访时间少于30天。993例开放性眼球损伤中共有586例纳入研究。主要观察指标为眼内炎发生率。
本研究中，25/586眼（4.3%）发生眼内炎。其中，12/25眼（48.0%）伤时即出现眼内炎，13/25眼（52.0%）在眼球闭合后发生眼内炎。多因素分析确定眼球修复时间（比值比4.5，可信区间1.9 - 10.7，p = 0.0008）、Ⅰ区损伤（比值比3.6，可信区间1.1 - 11.0，p = 0.0282）和需要再次手术（比值比5.5，可信区间1.5 - 19.7，p = 0.0092）为发生眼内炎风险增加的相关因素。眼球闭合时结膜下注射抗生素（比值比0.3，可信区间(0.1 - 0.7)，p = 0.0036）与发生眼内炎风险降低相关。
及时闭合眼球和结膜下使用抗生素可能降低OGI后眼内炎的风险。此外，我们一次性使用全身预防性抗生素以及在眼内异物（IOFB）取出延迟时使用玻璃体内抗生素的做法，未发现会增加眼内炎发生率。
