TY  - JOUR
PY  - 2002//
TI  - Endophthalmitis after deadly-weapon-related open-globe injuries: risk factors, value of prophylactic antibiotics, and visual outcomes
JO  - American journal of ophthalmology
A1  - Sabaci, Güngör
A1  - Bayer, Atilla
A1  - Mutlu, F. Mehmet
A1  - Karagul, Suat
A1  - Yildirim, Erol
SP  - 62
EP  - 69
VL  - 133
IS  - 1
N2  - PURPOSE: To identify clinical and microbiologic factors influencing the prevalence and visual outcomes in endophthalmitis after deadly-weapon-related open-globe injuries. METHODS: In a retrospective study of 228 eyes of 212 patients with deadly-weapon-related open-globe injuries, clinical and microbiologic factors influencing the prevalence and visual outcome in endophthalmitis were analyzed in detail. RESULTS: Twenty-nine eyes enucleated for irreparable damages at presentation were excluded. Nineteen eyes (18 patients) of 199 (186 patients) were associated with culture-proven endophthalmitis. Presence of grade 4 injury, a variable of Ocular Trauma Classification System, and lens disruption at presentation were the significant risk factors for development of endophthalmitis (P =.001; odds ratio = 15.9 [2.0 to 122.1]), and ([P <.001; odds ratio = 17.7 [2.3 to 136.3]), respectively. Favorable outcome (visual acuity of 5/200 or better) was achieved in only four eyes (21%). Five eyes (26.3%) were phthisical, and five eyes (26.3%) were enucleated or eviscerated. All eyes were under the coverage of prophylactic intravenous antibiotics when culture positivity was obtained. Except two eyes with Acinetobactersp., all were infected by gram-positive micro-organisms (89.5%), the most common of which (42%) was Staphylococcus epidermidis. None of the clinical characteristics and treatment modalities affected final visual outcome. Favorable outcome was associated with infection by the less virulent micro-organism S. epidermidis (P =.018; odds ratio = 0.50 [0.25 to 1.00]). CONCLUSIONS: Endophthalmitis after deadly-weapon-related open-globe injuries has a dismal visual prognosis. Severity of injury and lens disruption are significant risk factors for development of endophthalmitis. Infection with a less virulent microbe is the only factor associated with favorable outcome.<p /> <p>Language: en</p>
LA  - en
SN  - 0002-9394
UR  - http://dx.doi.org/
ID  - ref1
ER  -