Risk factors for culture-positive endophthalmitis after repair of open globe injuries.

PURPOSE: To identify risk factors for the development of culture-positive endophthalmitis after repair of open globe injuries.

METHODS

We retrospectively reviewed the medical records of 629 consecutive patients with open globe injuries admitted to King Abdulaziz University Hospital between May 1996 and January 2008.

RESULTS

Endophthalmitis developed in 12 (1.9%) patients. The following factors were significantly associated with endophthalmitis by univariate analysis: delayed presentation (>24 hours) (p=0.008), rural address (p=0.013), and dirty wound (p=0.012). Logistic regression analysis identified dirty wound to be associated with the development of endophthalmitis (odds ratio = 11.6; 95% confidence interval [CI] = 2.67-50.6). On logistic regression analysis, presence of retained intraocular foreign body (IOFB) in association with rural address (odds ratio = 11.0; 95% CI = 1.44-83.3) or dirty wound (odds ratio = 9.2; 95% CI = 1.22-69.1) was associated with development of endophthalmitis. Endophthalmitis was a significant negative predictor for final good visual outcome (p=0.00261) and was significantly associated with hypotony (p=0.033).

CONCLUSIONS

Delayed presentation, rural address, and dirty wound were associated with development of endophthalmitis. Retained IOFB in association with rural address or dirty wound was associated with a particularly high risk of endophthalmitis.