Antiseptics, Antibiotics Limit Infectious Keratitis After Foreign Body Removal

Antiseptics and antibiotics demonstrate similar efficacy for limiting infectious keratitis occurrence following corneal foreign body removal, according to a study published in Eye. Using a burr to perform the removal was associated with a longer healing time compared with using a needle, according to the report. 

Researchers included 307 individuals (mean age, 42.8 years; 300 men) who underwent corneal foreign body removal between June 2020 and June 2022 and treatment with an antiseptic (picloxydine; n=155) or antibiotic (tobramycin; n=152) during a 7-day period following the procedure. The primary outcome measure was the occurrence of infectious keratitis within a 30-day period. The cohort consisted primarily of building workers (50.2%), and a majority of participants did not wear eye protection (68.1%). Most corneal foreign bodies were metallic (95.1%) and rust was present in 72.1% of patients.  

Infectious keratitis occurred in 4.9% of participants — 5.3% of study participants had undergone antiseptic treatment compared with 4.5% of individuals who had undergone antibiotic treatment. No statistically significant differences were noted between the 2 groups (P =.797). 

A total of 61.1% (n=187) of participants underwent corneal foreign body removal using a 30 gauge needle compared with 38.9% (n=119) of participants who underwent the procedure with a burr. Corneal healing was delayed in 47.2% of participants at the 3-day follow-up visit, and this delay occurred primarily in patients treated with a burr (P =.003), according to the report. 

“There is no significant difference in the rate of infectious keratitis between the antiseptic group and the antibiotic group,” according to the researchers. “The social impact is limited with a majority of patients working the day after the corneal foreign body removal.”

Study limitations include a retrospective nature, high loss to follow up, and a lack of randomization.