The role of prophylactic intravitreal injection of antibiotics in open globe injuries

Ocular trauma is an important cause of preventable and predominantly monocular visual morbidity and blindness in the world.The aim of this work is to evaluate the safety and efficacy of intravitreal injection of antibiotics in the prevention of acute post traumatic endophthalmitis following open globe injuries.This is a prospective, randomised, case control study ,including one hundred and twenty eyes of 120 patients with open globe injury who presented to the emergency eye services of Zagazig university hospital.The patients were randomised into two groups.Group I: sixty patients (60 eyes) were given prophylactic intravitreal injection of vancomycin 2 mg in 0.1mg and ceftazidime 2.25 mg in 0.1 mg at the conclusion of primary repair.Group II: sixty patients (control group) (60 eyes) did not receive intravitreal antibiotics.Signs and symptoms must be evaluated with regard to the degree of traumatic injury and include decreased vision, pain greater than expected, lid swelling, corneal ring ulcer, anterior chamber inflammation, hypopyon, vitritis, or frank purulence .In the conclusion of this study, It is recommended to inject prophylactic intravitreal antibiotics at the end of primary repair of open globe injuries especially in high risk cases as delayed repair for more than 24 hours, contaminated dirty wounds, penetrating ocular injuries, and presence of intraocular foreign bodies and Initial evaluation of post traumatic endophthalmitis must exclude occult or retained foreign bodies. Prophylactic intravitreal antibiotics seem to prevent severe intraocular infection following open globe injury. This should be included as a standard of care.