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Corneal foreign bodies: are antiseptics and antibiotics equally effective?

Eye (2023)Cite this article

Subjects

Abstract

Purpose

To compare the effect of antiseptics and antibiotics on the occurrence of Infectious Keratitis (IK) secondary to Corneal Foreign Body (CFB) removal.

Methods

Multicenter retrospective study conducted between June 2020 and June 2022 in patients referred for CFBs and treated with Picloxydine (Group 1) or Tobramycin (Group 2) for 7 days. A follow-up visit was scheduled on Day 3 (D3) and a phone call on D30. The primary outcome measure was the occurrence of IK.

Results

307 patients (300 men) with a mean age of 42.8 (14.8) years were included. The mean (SD) time to consultation was 43.1 (45.6) hours. Picloxydine and Tobramycin were given to 155 and 152 patients. Half of patients (n = 154, 50.2%) were building workers and 209 (68.1%) did not wear eye protections. CFBs were mainly metallic (n = 292, 95.1%). Upon referral, rust was found in 220 patients (72.1%). A burr was used in 119 (38.9%) patients. IK occurred in 15 (4.9%) patients, 8 (5.3%) in Group 1 and 7 (4.5%) in Group 2 (p = 0.797). IK was successfully treated in all cases. Persistent rust was found in 113 patients (36.9%) on D3 without difference between burr or needle use (p = 0.278). On D3, corneal healing was delayed in 154 patients (47.2%), mainly in burr-treated patients (p = 0.003). The mean (SD) work stoppage duration was 0.32 (0.98) days.

Conclusion

IK rate was 4.9%. The efficacy of antibiotics and antiseptics was similar on CFB removal. Using a burr was associated with a longer healing time. CFBs had a limited social impact.

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Fig. 1: Composite figure sumarizing the study’s material and method.

Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity human data and are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Université Côte d’Azur, Hôpital Pasteur 2, Centre Hospitalier Universitaire de Nice, Service d’Ophtalmologie, Nice, France

    Benjamin Rebattu, Stéphanie Baillif, Thierry Ferrete, Sacha Nahon-Estève & Arnaud Martel

  2. Université Côte d’Azur, Hôpital l’Archet, Centre Hospitalier Universitaire de Nice, Service des Maladies infectieuses et tropicales, Nice, France

    Karine Risso

  3. Service d’Ophtalmologie, Centre Hospitalier d’Antibes, Antibes, France

    Alexandra Rabot

  4. Université de Montpellier, Service d’Ophtalmologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France

    Fanny Babeau

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  1. Benjamin Rebattu
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Contributions

The trial protocol was designed and written by the authors (BR, AM, SN). BR and FT collected all patients data. SN performed statistical analyses. SB, FB, AR, KR brings them clinical experience for the analysis of the results. The manuscript was written by BR, AM, and SN, together with all co-authors, who vouch for the accuracy of the data reported. All authors edited and approved the manuscript.

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Correspondence to Arnaud Martel.

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Rebattu, B., Baillif, S., Ferrete, T. et al. Corneal foreign bodies: are antiseptics and antibiotics equally effective?. Eye (2023). https://doi.org/10.1038/s41433-022-02380-0

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