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Poonam Misra, Sarah M Abbassi, Alain Bauza, Marco Zarbin, Neelakshi Bhagat; Characteristics and Demographics of Patients with Posterior Segment Intraocular Foreign Bodies. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5475.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the demographics, outcomes, and posterior segment (PS) complications in eyes with PS intraocular foreign bodies (IOFBs) that presented to University Hospital in Newark, NJ between 2004 and March 2013.
Retrospective chart review.
Of the 65 eyes identified with IOFBs, 30 had IOFBs in the PS only, 4 had IOFBs in both segments. The average age of patients was 37.8 years (range 20-63). Thirty-one IOFBs (91%) were metal, 2 glass (6%), and 1 plastic (3%). The size of IOFBs ranged from <1 to 24mm, with 21(62%) being 1-5 mm. Diagnosis was made by clinical exam, B-scan, and/or CT scans. Pre-operative visual acuity (VA) ranged from count fingers (CF) to 20/20, an average of 20/462. Final VA ranged from CF to 20/25, an average of 20/204. Twenty-six IOFBs (77%) were removed through surgical sclerotomies. All 34 eyes underwent open globe repair (OGR) within 24 hours of presentation; 30 underwent concurrent pars plana vitrectomy (PPV). The mean duration between time of injury and OGR was 2.35 days. IOFBs were removed from 32 (97%) eyes at the primary repair; in two cases, the PS IOFBs were not seen initially but noted on follow up B scan and CT scan, respectively. Five of 34 eyes received intravitreal antibiotics, Vancomycin and Ceftazidime, at OGR. All patients were given IV antibiotics for an average of 3.90 days. Twenty-four (71%) eyes presented with cataracts, 22 were left aphakic after pars plana lensectomy (PPL) with OGR. At presentation, 26 of 34 (77%) eyes had vitreous hemorrhage, 19 (56%) retinal detachment (RD), 1 (3%) hemorrhagic choroidals and 2 (6%) with endophthalmitis. Eleven eyes were noted to have retinal tears (without RD) intra-operatively. Eighteen of 19 eyes (95%) with RD underwent RD repair (RDR) at presentation (1 eye had RDR one week later). Six of 19(32%) underwent silicone oil tamponade, 14 (41%) endolaser photocoagulation, 9 (47%) gas tamponade, and 3 (9%) scleral buckle procedure. Two eyes were lost to follow-up. Anatomic success of after one RDR was 33% (6/17). Eleven of 17 (65%) eyes had recurrent RD with proliferative vitreoretinopathy (PVR). The overall anatomic success was 94% (16/17).
Posterior segment IOFBs are associated with vitreous hemorrhage, retinal tears and RDs. Overall anatomic success of retinal reattachment in patients was 94% in our series.
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