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Sahas Narain, Wei Wang, Harpal Sandhu; Complications and Visual Outcomes of Intraocular Foreign Bodies. Invest. Ophthalmol. Vis. Sci. 2018;59(9):6176.
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© ARVO (1962-2015); The Authors (2016-present)
Intraocular foreign bodies (IOFB) are a common consequence of facial trauma. Without proper removal IOFB injuries can cause permanent ocular damage that can lead to vision loss, infection and even enucleation of the eye. The purpose of this study was to review the treatment, outcomes, and complications of patients with intraocular foreign bodies presenting at a single, tertiary care, level one trauma center.
This study was a retrospective, observational, single-center study. 15 patients from the University of Louisville who underwent IOFB surgery from 2007 to 2017 with at least 2 months of follow-up were included. Pre- and post-operative data were recorded as well as procedure types and any subsequent complications.
The average age of presentation was 41.6 with a range of 76. Mean presenting vision was logMAR 1.44 with 2 eyes presenting with light perception only. 11/15 (73%) of patients had visual acuity greater than 20/40. Average vision at last follow up was logMAR 0.81. 10/15 (67%) of patients achieved a visual acuity of 20/40 or better. The most common location for IOFBs was in the vitreous cavity with 9/15 (60%) of patients presenting with IOFBs in the posterior segment. Average size for those recorded was 6.9 mm in longest dimension. 9/15 (60%) of patients had a metallic foreign body while the remainder included gravel, plastic, and thread. 5/15 (33%) patients had surgery on the same day while 3/15 (20%) had surgery more than a week after the injury. 10/15 (67%) of patients underwent pars plana vitrectomy (PPV) in order to extract the IOFB while 5/15 underwent manual forceps removal using an anterior approach. Of the PPV cases, 2/10 (20%) used a magnet for removal. 5/15 (33%) of patients required lensectomy during PPV. 13/15 (87%) of patients received topical Vigamox following surgery and 2/15 (13%) developed endophthalmitis. Only 1/15 patient underwent enucleation of the involved eye. 7/15 (47%) patients developed retinal detachment with subsequent surgeries. Those with RD had a mean final vision of logMAR 1.54.
Intraocular foreign body removal by either a pars plana approach for posterior segment IOFBs or anterior approach for anterior ones can improve vision. Endophthalmitis and retinal detachment are still common complications of these serious injuries and herald a poor visual prognosis.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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