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April 1999

Posttraumatic Endophthalmitis

Arch Ophthalmol. 1999;117(4):520-521. doi:10.1001/archopht.117.4.520

ENDOPHTHALMITIS AFTER penetrating ocular trauma remains a serious and often devastating complication. These infections are analogous to contaminated traumatic wounds in general surgery and must be approached with different expectations and strategies than postoperative endophthalmitis after cataract extraction. The incidence of endophthalmitis in eyes with penetrating trauma is reported from 3.3% to 17% in series from large institutions; the likelihood of infection is therefore approximately 100 times greater after penetrating trauma surgery than after elective cataract surgery. The setting and circumstances of trauma may have a striking effect on the incidence and severity of infection. One series demonstrated that eyes injured in a rural setting had a 30% incidence of infection compared with 11% of injuries in an urban environment.1 Contrary to older teachings, eyes with retained intraocular foreign bodies may be more likely to develop endophthalmitis than those with penetrating injuries but no foreign bodies. Rupture of the lens capsule and a delay from the time of injury to primary surgical repair are also risk factors for infection.2

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