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Auvni Patel, Nishant G. Soni, Alain Bauza, Marco A. Zarbin, Neelakshi Bhagat; Intraocular Foreign Bodies; A 9 Year Retrospective Review. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4955.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the demographics, characteristics, treatment, and functional and anatomic outcomes of traumatic open globe injury patients with surgically removed intraocular foreign bodies that presented to University Hospital, Newark, NJ between 2001 and May 2010.
Retrospective case series. 40 patients (41 eyes) with intraocular foreign bodies (IOFBs) requiring surgical removal were identified.
The mean age was 35.7 years (range 16-74, median 33); 100 % were males. Ethnic background included 17 (42.5%) Hispanic, 8 (20%) white, 7 (17.5%) black, and 7 (17.5%) other, and 1 (2.5%) not documented (N/D). Of the injuries, 22 (53.7%) were work-related and 5 (12.2%) were gunshot related. The IOFBs included 33 (80.5%) metallic, 5 (12.2%) glass, 1 (2.4%) wood, 1 eyelash, and 1 thorn. The length of time between injury and IOFB removal was within 24 hours in 33 (80.5%) cases (maximum time was 50 years). Three (7.3%) eyes were primarily enucleated, all due to destruction from gunshot wounds. No eyes in this series required a secondary enucleation. Three (7.3%) eyes developed endophthalmitis; 2 of them had posterior chamber injuries (final visual acuities (VA) of CF and 20/200); 1 had an anterior chamber injury (final VA 20/20). Injuries included 10 (25.6%) anterior chamber IOFBs with logMar mean initial VA of 0.597 and mean best corrected final VA of 0.197, 23 (59%) posterior chamber IOFBs with logMar mean initial VA of 1.288 and mean best corrected final VA of 1.056, and 6 (15.4%) both anterior and posterior chamber IOFBs with logMar mean initial VA of 1.5795 and mean best corrected final visual acuity of 0.882. 3 (7.32%) eyes presented with NLP and all three were primarily enucleated. On presentation, 35 (85.4%) of lens were phakic, 20 (48.8%) had cataracts, 3 (7.3%) were aphakic, 1 (2.4%) was pseudophakic, 1 had a posterior dislocation, and the status of 1 could not be determined due to 100% hyphema. On presentation, 19 (46.3%) eyes were noted to have vitreous hemorrhage (VH), and 10 (24.4%) retinal detachment (RD). Mean length of stay in the hospital on IV antibiotics was 4.32 days, with a median of 4 days, and a range of 1-17 days. The mean hospital stay for patients with enucleation was 5.5 days which is 1.2 (27.9%) days more than overall mean. Mean logMar initial VA was 1.353, with a mean VA at final follow-up of 0.77. Mean follow-up of 19.2 months.
Eyes with intraocular foreign bodies should receive emergent aggressive treatment since some eyes may have a fair visual potential; in our series 63% (26/41) eyes recovered to 20/200 or better VA. Eyes with posterior chamber IOFBs tend to develop more post-operative complications and have worse final VA.
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