Purchase this article with an account.
Lekha Mukkamala, Nishant Girish Soni, Paul D Langer, Marco A Zarbin, Neelakshi Bhagat; Outcomes of Traumatic Injury with Posterior Intraocular Foreign Bodies. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6063.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Penetrating eye trauma with posterior chamber (PC) intraocular foreign bodies (IOFB) may cause devastating sequelae of loss of vision or globe. In this retrospective chart review we aim to describe the presenting features, management, and outcomes of eyes with PC IOFB.
Chart review of patients with PC IOFB who presented to IOVS from 2003-June 2014 was conducted. Patient demographics, type of injury and IOFB, presenting exam [i.e. visual acuity (VA), Ocular Trauma Score (OTS), status of vitreous hemorrhage (VH) and retinal detachment (RD)], surgery and post-operative outcomes were analyzed. Numerical VA was calculated using LogMAR scale. Significance was based on p<0.05 with power of at least 80%.
Thirty one patients (28 males, 3 females; mean age 37 years) were identified. Type of IOFB is shown in Figure 1 and was diagnosed by CT in 67%. Most eyes had Zone 1 entry and OTS of 3 or 4 (8 and 7 respectively). One eye presented with endophthalmitis 6 days after injury. Mean follow up time was 17 months (range <1 to 84 mo).<br /> PC IOFB was removed within 24 hours of presentation in 28 of 31 patients. One patient opted for no removal and in 2 cases cilia were found 4 and 6 days later during RD repair. Characteristics of patients based on retinal status on presentation are shown in Table 1. RD was repaired with silicone oil tamponade in 56% of cases, with recurrence noted in 35% (Table 1). All patients received IV antibiotics during a mean hospital stay of 4 days; 3 also received intravitreal antibiotics (1 with endophthalmitis on presentation, 2 for prophylaxis).<br /> Mean presenting VA was CF; mean final VA was 20/200. Sixty percent of patients achieved VA predicted by OTS (3 better and 5 worse than expected). There was no correlation between initial and final VA (r2=0.11). Patients with RD on presentation had worse final VA than patients with no RD (p<0.05) (Table 1); however power was not adequate to prove significance. The most common complication was RD. One patient in which a second IOFB (cilia) was found 6 days later developed sympathetic ophthalmia. There were no cases of post-operative endophthalmitis. No eyes were enucleated.
Patients with posterior IOFBs have guarded visual prognosis, especially when presenting with concurrent RD. Final VA is well predicted by the OTS. Enucleations are rare.
This PDF is available to Subscribers Only