Visual Prognosis After Treatment of Endophthalmitis Associated With Intraocular Foreign Bodies Removal

Abstract

Abstract: : Purpose:Describe visual prognosis in eyes with endophthalmitis associated with intraocular foreign bodies (IOFB). Methods:: Retrospective review of patients with history of IOFB removal and development of endophthalmitis over the 20–years period at a tertiary eye care center. Results: There were 563 patients who had history of IOFB removal. The time of presentation after injury ranged from 30 minutes to 47 years. There were 508 (91%) males and 52 (9%) females with average age of 25 years (range 1 to 76). The entry of IOFB was anterior in 369 (65.5%) eyes, posterior in 112 (19.9%) eyes and anterior/posterior in 74 (13%) eyes. Location of IOFB was anterior in 158 (28%) eyes, posterior in 353 (62.7%) and anterior/posterior in 17 (3%) eyes. Most of the IOFB were metallic (66.4%) in nature, followed by non–metallic like wood (9%) and glass (11%). From this group of patients, 26 (4.5%) eyes developed endophthalmitis. After treatment of endophthalmitis and removal of IOFB the visual outcome improved in 17 (65%) eyes, worsened in 7 (26%) eyes and remained unchanged in 2 (7.5%) eyes. Longer duration of retained foreign bodies and multiple surgeries were poor prognostic factors for better visual prognosis. The anterior location of IOFB was a better prognostic factor for improved visual outcome. The follow on the patients after treatment ranged from 3 weeks to 20 years (average 24 months). Conclusions: Majority of patients with endophthalmitis associated with retained IOFB had improved vision after removal of IOFB and treatment of their endophthalmitis. The anterior location of IOFB was a better prognostic factor for improved visual outcome.

Keywords: endophthalmitis • trauma • visual acuity