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February 28, 2026Eye0 citationsOpen Access

Incidence of post-traumatic endophthalmitis following repaired open globe injury: impact of prophylactic intracameral moxifloxacin

KMK Mohamed-NoriegaUniversidad Autónoma de Nuevo LeónAHAlicia J. Hernández-MorenoUniversidad Autónoma de Nuevo LeónFMFernando Morales-WongUniversidad Autónoma de Nuevo León

Key Points

  • To evaluate the effectiveness of intracameral moxifloxacin in reducing post-traumatic endophthalmitis incidents after open globe injury repair.
  • Conducted an ambispective, consecutive, comparative study of OGI repair patients.
  • Divided patients into two groups: with and without intracameral moxifloxacin prophylaxis.
  • Both groups underwent standard povidone-iodine antisepsis.
  • Post-traumatic endophthalmitis occurred in 0.7% of the ICM group versus 3.9% in the No-ICM group.
  • ICM treatment showed a relative risk reduction of 82% for endophthalmitis after OGI repair.
  • The number needed to treat was 32 to prevent one case of endophthalmitis.

Abstract

Abstract Background/objectives To assess the effect of intracameral moxifloxacin (ICM) after repaired open globe injury (OGI) in reducing the incidence of post-traumatic endophthalmitis. Subjects/methods Ambispective, consecutive, comparative study of patients operated of OGI repair. Patients were divided into two groups: those without intracameral antibiotic prophylaxis (No-ICM) (operated between 2002 and 2012) and those with ICM prophylaxis at the end of the procedure (ICM) (operated between 2013 and 2023). Both received standard povidone-iodine antisepsis. Endophthalmitis was defined as severe intraocular inflammation associated with hypopyon and/or vitritis. Results 424 eyes (424 patients) were included, 294 in ICM group and 130 in No-ICM group. Male sex was 85.7% and 90.8% in ICM and No-ICM groups, respectively. The ICM group was significantly older than No-ICM group (median (IQR): 26 (14–41) vs. 21.5 (12–34), p = 0.025). The proportion of patients younger than 18 years was similar between ICM and No-ICM group (33.1% vs. 38.5%, p = 0.275). Post-traumatic endophthalmitis was significantly lower in ICM (2/294, 0.7%) compared to No-ICM (5/130, 3.9%) ( p = 0.031) group. Sensitivity analysis age-adjusted confirmed the protective effect of ICM for endophthalmitis after OGI was independent of age (adjusted OR: 0.20; 95% CI: 0.04–0.86; p = 0.031). The relative risk of endophthalmitis with ICM compared with no-ICM was 0.18 (0.04–0.78), with relative risk reduction of 82%, absolute risk reduction of 3.2%, and a number needed to treat of 32 to prevent one case of endophthalmitis following OGI repair. Conclusions ICM at the end of surgery reduces the incidence of post-traumatic endophthalmitis after OGI repair, compared with no intracameral antibiotic prophylaxis.

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Cite This Study

Mohamed-Noriega et al. (2026) studied this question.

synapsesocial.com/papers/69a286eb0a974eb0d3c023e5https://doi.org/10.1038/s41433-026-04338-y
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