Endophthalmitis after deadly-weapon-related open-globe injuries: risk factors, value of prophylactic antibiotics, and visual outcomes

Sabaci, Güngör; Bayer, Atilla; Mutlu, Fatih Mehmet; Karagül, Suat; Yıldırım, Erol

doi:10.1016/s0002-9394(01)01320-4

Cited by 82 publications

(63 citation statements)

References 25 publications

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“…In a previous study reported by our department, endophthalmitis following open-globe injuries was reported in 9% of the 199 eyes. 18 Although most of the injuries resulted from dirty materials such as rocks, stones, and metals covered with soil, the absence of any case of endophthalmitis was remarkable. In addition, with the exception of intravenous or oral antibiotic therapy, no patient received intraocular antibiotics preoperatively or at the time of surgery.…”

Section: Discussionmentioning

confidence: 99%

Ocular injuries from improvised explosive devices

Erdurman

Hürmeriç

Gokce

et al. 2011

Eye

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Purpose To document the characteristics, treatments, and anatomical and functional outcomes of patients with ocular trauma from improvised explosive devices (IEDs). Methods Retrospective review of ocular injuries caused by IEDs, admitted to our tertiary referral centre. Results In total, sixty-one eyes of the 39 patients with an average age of 24 years (range, 20-42 years) were included in the study. In total, 49 (80%) eyes of the patients had open-globe and 12 (20%) had closed-globe injury.In eyes with open-globe injury, intraocular foreign body (IOFB) injury was the most frequently encountered type of injury, observed in 76% of eyes. Evisceration or enucleation was required as a primary surgical intervention in 17 (28%) of the eyes. Twentytwo (36%) eyes had no light perception at presentation. Patients were followed up for an average of 6 months (range, 4-34 months). At the last follow-up, 26 (43%) of 61 eyes had no light perception. Postoperative proliferative vitreoretinopathy (PVR) developed in 12 (50%) of the 24 eyes that underwent vitreoretinal surgery, and four of these eyes became phthisical. There were no cases of endophthalmitis. The presence of open-globe injury and presenting visual acuity worse than 5/200 were significantly associated with poor visual outcome (o5/200, Po0.05).In eyes with open-globe injury, the presence of an IOFB was not associated with poor visual outcome (P40.05). Conclusion Ocular injuries from IEDs are highly associated with severe ocular damage requiring extensive surgical repair or evisceration/enucleation. Postoperative PVR is a common cause of poor anatomical and visual outcome.

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Section: Discussionmentioning

confidence: 99%

Ocular injuries from improvised explosive devices

Erdurman

Hürmeriç

Gokce

et al. 2011

Eye

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“…Four (14.8%) eyes were eviscerated. Visual outcome in posttraumatic endophthalmitis is generally poor as recorded by other workers, 21,25 but Brimton et al 28 had 26% of patients with final visual acuity of 6/9 (20/30) and 42.1% had 6/60(20/200) or better.…”

Section: Discussionmentioning

confidence: 86%

“…Endophthalmitis following openglobe injuries is caused by a specific range of microorganisms of which bacillus specie and coagulase negative staphylococcus are the most frequent. 25 The vitreous aspirate of only 1 (3.7%) patient yielded fungal septate hyphae, while E coli and Staphylococcus aureus were cultured in the specimen of one (3.7%) patient, though the B-scan showed infective process in 7 (25.9%) patients' vitreous cavities. Davey et al 26 have reported far less cases of fungal infection, but found bacillus species as increasingly major causes of posttraumatic ocular diseases.…”

Section: Discussionmentioning

confidence: 90%

Endophthalmitis: Magnitude, treatment and visual outcome in northwest frontier province of Pakistan

Wade

Khan

2009

Ann Afr Med

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Background Many cases of post-operative and posttraumatic endophthalmitis are being managed at the Khyber Institute of Ophthalmic Medical Sciences, Peshawar in Pakistan but no study has been done to ascertain the magnitude of the disease and to also evaluate the visual outcome after management. Methods The case notes of 39 patients diagnosed with posttraumatic and postoperative endophthalmitis between May 2006 and April 2007 were analyzed and clinical characteristics obtained were documented and tabulated Results During the study period, 2474 patients were admitted in both the male and female wards. Of these, 39 (1.6%) had endophthalmitis due to surgical and traumatic complications. In all, 6 (12.4%) patients had evisceration, while 21 (53.8%) patients who had topical antibiotics consisting of ofloxacin, 0.1% corticosteroids, fortified cetazoline and 1% atropine along with intravitreal antibiotics, a combination of 0.1mg vancomycin and 0.4mg amikacin, were discharged home with a visual acuity of counting fingers to light perception. Conclusion Endophthalmitis is a serious ocular complication of open globe injury and intraocular surgery. The frequency in this center has been noted to be very high as compared to other places. Its management is very challenging and often leads to devastating structural and functional damage to the eye; causing severe frustration to both the patient and the attending physician. Efforts must be made to prevent the condition.

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“…The incidence of endophthalmitis varies, though its development after weapon-related globe rupture is associated with an extremely poor visual prognosis. 19 Both the delayed timing of primary repair 20 and delayed administration of systemic antibiotics beyond 24 hours 21 has been shown to be associated with a higher risk of developing posttraumatic endophthalmitis. Our patient received IV cefazolin in the ED, rapid surgical intervention by an ophthalmologist and postoperative administration of IV ciprofloxacin.…”

Section: Discussionmentioning

confidence: 99%

Ophthalmic injuries from a TASER

Han

Chopra

Carr

2009

CJEM

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ABSRACTThe TASER (TASER International) is an energy-conducting weapon, that is becoming more frequently used by law enforcement officials to subdue combative individuals. Though generally regarded as a safe alternative, the use of such weapons has been reported to cause serious injuries. We describe a case in which ocular injuries were sustained by impalement with a TASER dart. Emergency physicians should be aware of the potential for serious ophthalmic injuries from TASERs and how such injuries should be managed. RÉSUMÉLe pistolet TASER (TASER International) est une arme à impulsions électriques que les responsables de l'application de la loi utilisent de plus en plus fréquemment pour neutraliser les individus combatifs. Bien que l'emploi de cette arme soit généralement considéré comme une méthode d'immobilisation sûre, son déploiement a causé des traumatismes graves. Nous décrivons un cas de blessure oculaire par empalement du dard d'un pistolet paralysant. Les médecins d'urgence doivent être conscients de la possibilité de blessures oculaires graves que les pistolets TASER peuvent causer et savoir quelle est la prise en charge dans de tels cas.

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Endophthalmitis after deadly-weapon-related open-globe injuries: risk factors, value of prophylactic antibiotics, and visual outcomes

Cited by 82 publications

References 25 publications

Ocular injuries from improvised explosive devices

Ocular injuries from improvised explosive devices

Endophthalmitis: Magnitude, treatment and visual outcome in northwest frontier province of Pakistan

Ophthalmic injuries from a TASER

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