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David Kilpatrick, Jordan Burnham, Ching Jygh Chen; Outcomes of Intraocular Foreign Body Injuries. Invest. Ophthalmol. Vis. Sci. 2018;59(9):6179.
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The visual prognosis of intraocular foreign body (IOFB) injury has not been well defined at the University of Mississippi Medical Center (UMMC). To understand this complex injury and better counsel our patients, we performed a retrospective chart review exploring the outcomes of IOFB injury presenting to Mississippi’s only Level 1 trauma center.
Our retrospective chart review includes 37 patients from June 2012 to March 2017 who presented to the University of Mississippi Medical Center with an IOFB injury needing surgical intervention. Reviewed data includes the location and type of IOFB, presence of retinal detachment, and mechanism of injury. Post-operative data analyzed includes final visual acuity, need for additional surgery, and complications.
37 patients were identified during the study period. The average age was 31 years old (range 4 to 61) and 92% were male. 86% of all IOFBs were metallic and the most common location for the IOFB was the retina (66%). The other main IOFB locations were the vitreous (14%), anterior chamber (11%), and cornea (8%). Final visual acuity was worse than 20/400 in 46% (24% being NLP) and better than 20/40 in 35%. 56% of intraoperative cultures were positive and coagulase negative staphylococcus was the most common isolate (74%). No patient developed post-operative endophthalmitis and all received clindamycin, vancomycin, and dexamethasone intravitreal injections at the time of IOFB removal. 81% of patients required pars plana vitrectomy during IOFB removal and 62% had a retinal detachment (RD) on presentation. Two of the 14 patients without a RD on presentation subsequently developed one. Excluding patients requiring an enucleation, if the IOFB was lodged in the retina the average total number of surgeries was three. 74% required at least one additional surgery including 6 enucleation or evisceration. BB IOFB was found in seven patients, of which five required enucleation and the remaining two were NLP.
IOFBs are potentially devastating injuries with a high likelihood of decreased final visual acuity. While each case is different, the location and type of IOFB may help give the surgeon and patient an idea of visual prognosis and need for additional surgery. By looking at the IOFB injuries that have presented to UMMC, our department can better counsel patients on the road to recovery from this type of injury.
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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