A new study sought to compare the rates of endophthalmitis and visual outcomes in open globe injuries without intraocular foreign bodies repaired within 24 hours, 25 to 36 hours, and greater than 36 hours.
The retrospective review, published in Ophthalmology as a pre-proof, included 2,002 cases of open globe injuries (OGIs) presenting to a single institution. Patients with OGIs were admitted and managed according to a standardized protocol. The main outcomes measured were rates of endophthalmitis and postoperative visual acuity at logMAR 1.3, logMAR 1.0, and logMAR 0.3 at 180 days and 1 year following open globe repair.
Of the total patients identified, 620 cases were excluded due to missing clinical information or the presence of intraocular foreign bodies, resulting in a total of 1,382 patients analyzed. Of these, 75% were male who were an average age of 41 years. The maximal zone of injury was zone 1 for 468 patients, zone 2 for 529 patients, and zone 3 for 508 patients. Eighty-four percent of repairs were conducted within 24 hours, 9% within 25 to 36 hours, and 7% after 36 hours. Delays in repair beyond 36 hours were significantly associated with female patients (p=0.042) and increased rates of endophthalmitis (p=0.049). However, neither repairs performed within 25 to 36 hours, nor injury zone showed a significant association with endophthalmitis rates (p=0.111).
“Although repair of OGIs within 24 hours is the current standard of care, this study found no statistically significant difference in rates of endophthalmitis or impact on visual outcomes in eyes undergoing repair within 24 hours of injury compared to repair extending to 25 to 36 hours. Endophthalmitis rates did increase after 36 hours. We recommend urgent repair of open globe injuries, but in certain circumstances, it may be reasonable to delay repair beyond 24 hours to optimize operating conditions,” concluded investigators.
A full list of author disclosures is available in the published research.