Purpose:
To describe the characteristics, demographics, and anatomic and functional outcomes in patients who underwent surgical removal of glass intraocular foreign bodies at University Hospital.
Methods:
Retrospective chart review of patients with glass intraocular foreign bodies who presented to University Hospital in Newark, NJ between 2000 and 2010.
Results:
Eleven ruptured globes with glass intraocular foreign bodies were identified. Of the 11 patients, 9 were male. The average patient age at the time of the injury was 24.6 years, ranging from 17 to 41 years. Of these 11 IOFB cases, 5 were in the anterior segment, 5 in the posterior segment, and 1 had glass in both the anterior and posterior segments. The entry wound was located in zone I in 4 patients, zone II in 3 patients, and zone III in 4 patients. Motor vehicle accidents and violence were the most common causes of injury, accounting for 6 and 4 of the cases respectively. The mean logMAR vision at presentation was 2.0, ranging from 2.5 to 1.6. The mean best-corrected visual acuity in logMAR units at the last date of follow-up was 1.7, ranging from 3.0 to 0.18. The average length of follow-up was 33.8 months (range 0.5-69 months). The mean time between injury and surgery was 0.4 days (range 0-1 days) while the mean time the patient had a foreign body in the eye was 4.1 days (range 0-25 days). Eight patients presented with traumatic cataracts, of which 3 had anterior segment IOFBs, and 5 had posterior segment IOFBs. Six patients presented with iris pathology; including a hole in the iris (1), iridodialysis (1), prolapsed iris (2), and others (2). Anterior segment pathology at presentation included hyphema in 4 patients and vitreous hemorrhage in 1. Of the 5 patients with posterior segment injuries all had vitreous hemorrhage and hyphema, 2 had retinal detachment, 2 had retinal tears, and 1 had hemorrhagic choroidals at presentation. Ten of the 11 eyes underwent IOFB removal during the initial surgery. Nine patients needed additional surgeries. Surgical procedures included intraocular foreign body removal, ruptured globe repairs, pars plana vitrectomies, lensectomies, and enucleations.
Conclusions:
Visual prognosis with glass intraocular foreign body is guarded or poor.
Keywords: trauma • clinical (human) or epidemiologic studies: outcomes/complications • clinical (human) or epidemiologic studies: natural history