Global current practice patterns for the management of open globe injuries.
Miller, Sarah C Fliotsos, Michael J Justin, Grant A Yonekawa, Yoshihiro Chen, Ariel Hoskin, Annette K Blanch, Richard J Cavuoto, Kara Meeralakshmi, Prajna Low, Rebecca
Miller, Sarah C
Fliotsos, Michael J
Justin, Grant A
Yonekawa, Yoshihiro
Chen, Ariel
Hoskin, Annette K
Blanch, Richard J
Cavuoto, Kara
Meeralakshmi, Prajna
Low, Rebecca
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2021-08-18
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Abstract
Purpose: To determine global current practice patterns for the management of open globe injuries and identify areas of variation.
Design: Cross-sectional survey.
Methods: An online survey assessed global management paradigms for open globe injuries from August 2020 to January 2021. Responses were collected from experts at eye trauma centers and emergency departments worldwide who manage ≥1 open globe injury per month. The survey assessed the use/selection of antibiotics and steroids, procedural and imaging decisions, and admission practices for open globe injuries.
Results: Responses were received from representatives of 36 of 42 institutions (85.7%), of which 33 (78.6%) had sufficient trauma volume to be included. Included responses were distributed across North America (n=12, 36.4%), Asia (n=12, 36.4%), South America (n=4, 12.1%), Africa (n=3, 9.1%), Europe (n=1, 3.0%), and Australia (n=1, 3.0%). Preoperative systemic antibiotics for open globe injuries were administered by 75.8% (n = 25/33) of institutions, while 30.3% (n = 10/33) administered preoperative topical antibiotics. Intraoperative ophthalmic antibiotics for open globe injuries were used by 54.5% (n = 18/33) of experts. Most institutions also administered postoperative systemic antibiotics (n = 23 [69.7%]) and topical steroids (n = 29 [87.9%]), although specific medication choices diverged. At 19 responding centers (61.3% of the 31 that had trainees), residents participated in surgical repairs. Many institutions discharged patients after repair, but 54.5% (n = 18/33) of locations routinely admitted them for observation.
Conclusions: Preferred management practices for open globe injuries vary widely. To ensure the highest standard of care for all patients, evidence-based international guidelines for the treatment of these injuries are needed.
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Miller SC, Fliotsos MJ, Justin GA, Yonekawa Y, Chen A, Hoskin AK, Blanch RJ, Cavuoto K, Meeralakshmi P, Low R, Gardiner M, Liu TYA, Agrawal R, Woreta FA; International Globe and Adnexal Trauma Epidemiology Study (IGATES). Global Current Practice Patterns for the Management of Open Globe Injuries. Am J Ophthalmol. 2022 Feb;234:259-273. doi: 10.1016/j.ajo.2021.08.003. Epub 2021 Aug 18
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Article