Open-Globe Injuries With Retained Intraocular Foreign Bodies: Anesthesia Options and Endophthalmitis Rates

Abstract

Purpose: To evaluate 1) anesthesia options and 2) endophthalmitis rates in patients with open-globe injury and retained intraocular foreign bodies. Methods: This retrospective, consecutive, nonrandomized comparative study analyzed eyes with open-globe injury and retained intraocular foreign body treated between January 1, 2015, and December 1, 2023. Results: A total of 134 eyes were included. Regional anesthesia with monitored anesthesia care (MAC) was used in 128 eyes (96%) at initial surgery. There was no difference in mean best-corrected visual acuity (BCVA) at last follow-up between eyes that received general anesthesia (1.39 [20/491]) and those that received regional anesthesia with MAC (0.81 [20/129]; P = .12). Endophthalmitis was diagnosed pre- or intraoperatively in 11 eyes (8%) and postoperatively in 2 eyes (1%) with an associated wound infection. Subconjunctival antibiotics were administered in 132 eyes (99%) and intravitreal (IVT) antibiotics in 130 eyes (97%). Eyes that received intraoperative IVT antibiotics were less likely to develop postoperative endophthalmitis (1 of 130 [0.8%]) compared with those that did not (1 of 4 [25%]; P < .001). Conclusions: Regional anesthesia with MAC was the most common form of anesthesia used during surgery. The use of intraoperative IVT antibiotics was associated with a lower rate of postoperative endophthalmitis.