Standardize Management of Intraocular Foreign Bodies (IOFBs) of the Posterior Segment at the XV-XX National Hospital of Paris

Abstract

Purpose: : The intraocular foreign bodies ( IOFBs) of the posterior segment are the major cause of poor vision. Their management has to be made standardized to minimize the poor visual outcome.

Methods: : Retrospective analysis over 5 years including seventy consecutive cases managed at the XV-XX national hospital of Paris between January 1st, 2004 and December 31st, 2008. The pre-operative and post-operative best corrected visual acuity (BCVA), the nature and the size of the IOFBs, the entry site, the time between the traumatism and the surgical ablation, the precise location of the IOFBs in the eye, the existence of a retinal detachment, the choice of the tamponade agent (none, gas, silicone oil), the complications (siderosis, endophtalmitis, retinal detachment with proliferation vitréorétinal proliferation) were studied.

Results: : The main prognostic factors related to better visual outcome were initial BCVA, time of surgery (first week), initially attached retina, scleral entry site rather than corneal. The main complications were represented by siderosis from the 3rd week, vitreoproliferative retinal detachment and endophthalmitis.Location, material and size of IOFBs were not statically significant predictive factors in this study.

Conclusions: : Managment of intraocular foreign body is a medical and surgical emergency which must be handle by a retinal surgery. The timing is primarily determinant today - not just because of the threat of endophthalmitis but also siderosis and retinal detachment. An optimized and interventional standardized management should allow to reduce late expected complications.

Keywords: vitreoretinal surgery • trauma