36-Hour Window Safe for Globe Injury Repair

TOPLINE:

Delaying the repair of open globe injuries up to 36 hours does not increase the risk of developing endophthalmitis or worsen visual outcomes compared with repairs done within 24 hours; however, repairs after 36 hours increase the odds of developing endophthalmitis.

METHODOLOGY:

• Researchers conducted a retrospective chart review of 1382 patients (average age, 41 years; 75% men) with injuries to the eyewall without intraocular foreign bodies, who were treated between 1999 and 2022.
• Among the patients, 84% had surgical repairs within 24 hours, 9% between 25 and 36 hours, and 7% after 36 hours.
• The study outcomes were endophthalmitis and postoperative visual acuity at 180 days and 1 year following surgical procedure.

TAKEAWAY:

• Only 13 cases of endophthalmitis were documented.
• The rates of endophthalmitis increased significantly when repair was delayed beyond 36 hours than when done within the current standard of care 24 hours (2.0% vs 0.3%; P = .049).
• This study found no statistically significant difference in the rates of endophthalmitis or visual outcomes for repairs done within 24 hours or ≤ 36 hours (P = .111).
• The timing of repair did not affect visual outcomes at 180 days or 1 year.

IN PRACTICE:

The authors supported the urgent repair of open globe injuries, but in certain circumstances, delaying repair beyond 24 hours to optimize the operating conditions may be reasonable.

SOURCE:

The study was led by Marisa G. Tieger, MD, of the Tufts University School of Medicine at the New England Eye Center in Boston and published online on July 2, 2024, in Ophthalmology.

LIMITATIONS:

The study was conducted at a single center. Other limitations were the retrospective study design, missing data, and variations in clinical management.

DISCLOSURES:

The study did not receive any funding. The authors reported no conflicts of interest. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.