Visual Outcomes and Prognostic Factors of Traumatic Endophthalmitis Treated by Pars Plana Vitrectomy: 11 Years Retrospective Analysis

Abstract

Aim: To evaluate the visual outcome of traumatic endophthalmitis and describe the risk factors associated with poor visual acuity and retinal detachment (RD) development over an 11-year period. Methods: Medical records of 34 patients with traumatic endophthalmitis who underwent PPV over a period of 11 years (1 January 2010–31 December 2020) were reviewed. We extracted details regarding demographic data, initial and final best corrected visual acuity (BCVA) using a standard Snellen chart, wound and IOFB characteristics, ocular associated lesions, and treatment. The outcome was evaluated according to the final BCVA which was defined as poor < 0.1 or good ≥ 0.1 Results: Endophthalmitis rate was 29.8% in open globe injuries. The mean age was 43.6 ± 16.5 years and the majority of patients were males (32 out of 34, 94.1%). All patients received systemic (moxifloxacin) and intravitreal antibiotherapy. We performed pars plana vitrectomy (PPV) in all cases. Poor visual outcome was associated with wound size ≥ 3 mm (p = 0.02), the association of IOFB (p = 0.016), and the development of RD (p = 0.00). The presence of IOFB (p = 0.01) and wound size ≥ 3 mm (p = 0.01) were statistically associated with RD development. After treatment, 47.05% of patients achieved final BCVA ≥ 0.1. Conclusion: Wound size ≥ 3 mm, IOFB and RD were risk factors for poor visual outcomes in traumatic endophthalmitis.

Early Vitrectomy for Endophthalmitis: Are EVS Guidelines Still Valid?

“…While the optimal timing and necessity of vitrectomy remain uncertain, some retrospective studies suggest that it may not always be superior to intravitreal antibiotics alone [ 28 , 29 ]. In contrast to these studies, a recent retrospective study by Hapca et al [ 30 ] examined 17 eyes with penetrating injuries but without intraocular foreign bodies. Among these cases, nine underwent PPV with intravitreal antibiotics at the end of surgery, while 8 cases received intraocular antibiotics first, followed by PPV.…”

Visual Outcomes of Traumatic Lens Dislocations and Subluxations Managed by Pars Plana Vitrectomy and Lensectomy

“…While an isolated lens pathology carries a very good prognosis, the final visual outcome in patients with trauma is usually poorer because of the associated lesions [5]. Vitreous hemorrhage (VH) is a complication observed in 12-19% of cases [6], intraocular foreign bodies (IOFBs) can exhibit a incidence from 6% to 42% in open globe injuries (OGIs) [7][8][9][10], and endophthalmitis, a severe inflammatory condition, may potentially complicate the OGI in up to 17% of cases [11,12]. The current management strategy in traumatic lens subluxation and dislocation is pars plana vitrectomy (PPV) combined with lensectomy, which provides the possibility to remove the lens as well as treat posterior segment complications [13].…”

Features and Outcomes of Penetrating Keratoplasty in Combined Opto-reconstructive Surgery for Combat Eye Injury and its Complication

“…По данным литературы, на исход сложных комбинированных ОРХ влияет число поврежденных структур, локализация зоны повреждения, размер и локализация ВГИТ, срок, прошедший от момента травмы, длительность операции, исходные электрофизиологические показатели и сопутствующие осложнения [5,[7][8][9][10][11]. Использование высокотехнологичной хирургической техники позволяет восстановить герметичность глаза и правильные внутриглазные анатомические взаимоотношения, однако окончательные функциональные результаты нередко остаются достаточно низкими из-за синдрома взаимного отягощения, обусловленного обширным повреждением большого количества структур глаза, а также световоспринимающих и проводящих структур [5,12].…”