Purpose
To evaluate outcomes and identify prognostic factors in patients with traumatic corneal foreign body injuries.
Methods
A retrospective chart review was performed of all patients with traumatic corneal foreign body injuries treated by one corneal specialist at the University of Colorado Department of Ophthalmology, from January 8, 2008 through November 6, 2013. The primary outcome of the study was visual acuity, with a poor outcome defined as loss of one or more lines of Snellen visual acuity or a final best corrected visual acuity worse than 20/40 at final follow up. Patient demographics, injury characteristics and treatment methods were recorded and analyzed in order to assess the potential relationship to visual outcome.
Results
A total of 534 consecutive cases were reviewed, of which 387 were included in the study. Overall, 9.8% of patients had a poor outcome. Improvement in Snellen acuity by 1 or more lines was seen in 66.9% of patients. Time to presentation, foreign body location, foreign body material, removal method, and post removal patching or bandage contact lens use were not associated with a significant difference in patient outcomes. Treatment with fluoroquinolone antibiotics after foreign body removal was associated with a statistically significant reduction in poor outcomes (p=0.0198), as was delayed treatment with topical steroids (OR 0.427, p=0.0298).
Conclusions
The incidence of poor outcomes is low in patients suffering from a corneal foreign body injury. Patients should be treated with fluoroquinolone antibiotics and delayed topical steroids following foreign body removal in order to reduce the incidence of poor outcomes.