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Endophthalmitis is a rare but devastating complication of open globe injury. Its occurrence aggravates visual prognosis of traumatised eyes and always troubles ophthalmologists. Prompt antibiotic prophylaxis is recommended by physicians 1 2 3 4 when traumatic endophthalmitis is suspected. Thus, identifying high-risk cases is crucial in avoiding any delay in diagnosis and initiation of treatment. A survey of literature reports indicates that there is no necessary correlation between the results of intraocular contents culturing and development of endophthalmitis. 1 5 6 This multicentre review of cases with open globe injury attempts to identify risk factors for post-traumatic endophthalmitis and describes its characteristics and treatment outcomes.
Methods
The medical records of all patients with open globe injury admitted to 15 tertiary referral hospitals in China between 1 January 2001 and 31 December 2005 were retrospectively reviewed. Each case was recorded in a standardised preformulated data sheet and in the computerised database of eye injury. This study included 4968 eyes of 4865 patients with open globe injuries admitted to the 15 tertiary referral hospitals of China over 5 years. A total of 173 eyes (one bilateral rupture of a male eye) enucleated or eviscerated within 24 h after trauma were excluded.
In this study, classification and definition of ocular trauma were based on the Birmingham Eye Trauma Terminology (BETT). Open globe injury indicates a full-thickness wound of the eyeball. A rupture wound is produced by an inside-out mechanism caused by a blunt object, whereas a laceration wound (including penetrating, intraocular foreign body (IOFB) and perforation) occurs at the impact site by an outside-in mechanism caused by a sharp object. Self-sealing wounds indicate that the wounds of globe wall closed tightly by themselves without primary repair. Intraocular tissue prolapse means that the intraocular tissues (including vitreous body, uvea, retina and lens) slipped out through wounds partly and were incarcerated there. The diagnosis of injuries was finally made by determining the mode of injury and by the findings during operation. Diagnosis of endophthalmitis was made chiefly by the clinical characteristic symptoms and signs. Culturing of intraocular contents was made only in certain cases. The outcomes of culturing were not considered in the diagnosis of endophthalmitis.
A standardised data sheet was completed for each case of ocular trauma. Information...