Abstract
BackgroundEndophthalmitis after open globe injury can be devastating to vision recovery. As treatment of endophthalmitis is often empiric, some surgeons may obtain cultures at presentation of trauma in anticipation of later infection. This study examines the usefulness of wound cultures obtained during globe repair.ResultsInstitutional Review Board approval was obtained. Medical records were retrospectively reviewed, with 168 open globes included. Cultures of the wound site had been taken in all cases included in this study. Wound cultures were positive in 63% of cases but were not used for clinical decision-making for any patient in this study. Two patients had evidence of endophthalmitis at presentation, with results of vitreous culture matching those from the wound. No patient later developed endophthalmitis after open globe repair.ConclusionsDespite a high rate of wound contamination, few cases of endophthalmitis (1.2%) were seen in this series. In no case did the results of wound culture impact choice of antibiotic prophylaxis or treatment. Cultures obtained at the time of open globe repair were not cost effective in the subsequent management of the injury.
Highlights
Endophthalmitis after open globe injury can be devastating to vision recovery
None of the remaining 227 eyes screened for this study developed endophthalmitis, and their culture results were not used for the remainder of their care
For the two patients with endophthalmitis at presentation, vitreous cultures were obtained that matched wound cultures
Summary
Endophthalmitis after open globe injury can be devastating to vision recovery. As treatment of endophthalmitis is often empiric, some surgeons may obtain cultures at presentation of trauma in anticipation of later infection. This study examines the usefulness of wound cultures obtained during globe repair. Open globe injury results from penetration or perforation in sharp or projectile trauma or from rupture in blunt trauma [1]. Endophthalmitis is a potentially devastating sequela of open globe injury. Staphylococcus and Streptococcus species are common causative agents [7], as they are skin flora and may enter through an open wound [2]. Some surgeons may obtain samples for culture at the time of globe repair to have a responsible microbial agent identified by the time the clinical picture worsens [8, 9].
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