Abstract
Abstract: :
Purpose: To describe and evaluate the epidemiological factors, clinical features and visual outcome of patients with penetrating ocular injury and retained intraocular foreign body (IOFB) Methods: Retrospective, longitudinal and descriptive review of the records of patients with penetrating ocular injury and retained IOFB, admitted to our hospital between January 1996 and December 2000. All eyes underwent primary surgical repair and IOFB removal. Age, gender, type of foreign body, interval between trauma and medical attention and surgical management, extent of ocular injury, surgical intervention, complications and final visual acuity were assessed. Results: Records of 75 patients (75 eyes) were evaluated, with an average follow-up time of 6.9 months (range 3 days to 50 months). 96% of the patients were male. Mean age was 26.3 years (range 3 to 67 years). The average length of time between trauma and attendance to a health center was 6.92 days (range 3 hours to 63 days), 28% received ophthalmologic care elsewhere prior to admission and 72% received attention only at our center. The cause of injury was: work-related accidents, home-related accidents or not specified in 33%, 13.7% and 37% of the cases respectively. The IOFB composition was metal in 79%, wood 9.7%, stone 7% and glass 4.3%. All patients underwent surgical procedure to remove the IOFB; 81.3% underwent vitrectomy (29.3% of these underwent scleral buckling also), 68% lensectomy and 2.7% penetrating keratoplasty. Final visual acuity was equal to or better than 20/40 in 26%, 20/50 to 20/200 in 15%, less than 20/200 in 35% and no light perception in 24%. The main complications were: retinal detachment (16.7%), endophthalmitis (14.2%), intraocular hemorrhage (12%), hypotony (2.7%) and cataract (2.7%). 1.3% required evisceration. Conclusion: Most IOFBs were of metallic nature and were found in males of productive age as a consequence of work-related accidents. Most patients required vitrectomy to remove the IOFB and even though good visual results were obtained in many cases, an important number of patients suffered severe visual impairment because of related complications.
Keywords: 608 trauma • 353 clinical (human) or epidemiologic studies: outcomes/complications