Management of open globe injury: a narrative review.

Autor: Blanch RJ; Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK. r.j.blanch@bham.ac.uk.; Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK. r.j.blanch@bham.ac.uk.; Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. r.j.blanch@bham.ac.uk., McMaster D; Imperial College London, London, UK., Patterson TJ; Northern Ireland Medical and Dental Training Agency, Belfast, UK.
Jazyk: angličtina
Zdroj: Eye (London, England) [Eye (Lond)] 2024 Nov; Vol. 38 (16), pp. 3047-3051. Date of Electronic Publication: 2024 Jul 31.
DOI: 10.1038/s41433-024-03246-3
Abstrakt: Open globe injuries are a significant global cause of visual loss, including unilateral and bilateral blindness. Prognosis is predicted by injury severity, with lower presenting visual acuity and more posterior injuries associated with poor visual outcomes, although even the most severely injured eyes with no perception of light vision may regain some visual function. In addition to severity of the primary injury, the secondary injuries and complications causing poor outcomes include proliferative vitreoretinopathy (PVR) and endophthalmitis. Endophthalmitis is common after open globe injury, affecting up to 16.5% of patients. Systemic antibiotic prophylaxis is commonly used, with a limited evidence base, while intraocular antibiotics are less commonly used but have stronger supporting evidence of efficacy. Endophthalmitis rates are also reduced by prompt primary repair, which may also support recovery of visual acuity. PVR is not prevented or treated by any pharmacologic interventions in current clinical practice, but the incidence of post-traumatic PVR may be reduced by early vitrectomy within the first 4-7 days after injury. Ocular trauma training is often limited in Western ophthalmic surgical training programmes, and patients with ocular trauma often require the input of multiple subspecialists. In this context, it is important that patients have an overview and coordination of the different aspects of their care, with ownership by one lead clinician.
(© 2024. Crown.)
Databáze: MEDLINE
Externí odkaz: