Clinical presentations and surgical outcomes of intraocular foreign body presenting to an ocular trauma unit

Anguita, Rodrigo; Moya, Rene; Saez, V.; Bhardwaj, Gaurav; Salinas, Alejandro; Kobus, Rudolf; Nazar, Cristóbal; Manriquez, Rodolfo; Charteris, David G.

doi:10.1007/s00417-020-04859-6

Cited by 17 publications

(18 citation statements)

References 30 publications

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“…The patients' age was not associated with visual outcomes. We did not observe any association between wound location and visual outcome, which is consistent with the findings reported by Anguita et al [ 11 ]. The nature of the IOFBs and the absence or presence of concomitant traumatic cataract were unrelated to visual outcome also.…”

Section: Resultssupporting

confidence: 93%

“…IOFBs in the posterior segment have a greater tendency to damage the retina and can cause irreversible vision loss when the macula and papillomacular bundle are involved. However, Anguita et al adopted the opposite view, concluding that IOFB location was not significantly associated with visual outcome [ 11 ]. This view was based on the authors' observation that IOFBs in the posterior segment were mostly located in the vitreous cavity and did not cause retinal damage.…”

Section: Resultsmentioning

confidence: 99%

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Intraocular Foreign Bodies: Clinical Characteristics and Factors Affecting Visual Outcome

Liang

Liu

et al. 2021

Journal of Ophthalmology

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Objective. To investigate the clinical characteristics and factors affecting visual outcome in patients with intraocular foreign bodies (IOFBs) and determine the risk factors for the development of endophthalmitis. Study Design. A retrospective case-series study design was adopted. Subjects. In total, 242 patients (242 eyes) who were hospitalized and underwent surgical treatment for IOFB at the Second Hospital of Hebei Medical University between January 1, 2008, and December 31, 2019, were included. Methods. The demographic data, cause of injury, characteristics of IOFBs, postinjury ocular manifestations, and surgical details of the subjects were collected, and the factors affecting visual outcome and endophthalmitis development were analyzed. Results. The most common cause of IOFBs was the propulsion of foreign bodies into the eye due to hammering (149 cases, 61.57%), followed by foreign body penetration (57 cases, 23.55%). Most of the subjects were young adult men who sustained injuries in the work environment. Poorer visual outcomes were found in subjects with initial presenting symptoms visual acuity (PVA) < 0.1, largest IOFB diameter ≥ 3 mm, IOFBs located in the posterior segment, wound length > 5 mm, entrance wound length larger than the largest IOFB diameter, concomitant retinal detachment, concomitant vitreous hemorrhage, concomitant endophthalmitis, and concomitant proliferative vitreoretinopathy (PVR). Factors related to the development of endophthalmitis included lens capsule rupture, time of stage 1 repair surgery ≥ 24 h after trauma, removal of IOFBs ≥ 24 h after trauma, and nonadministration of intravitreal antibiotic injection. Conclusion. Among patients with IOFBs, initial PVA < 0.1, entrance wound length larger than the largest IOFB diameter, concomitant endophthalmitis, and concomitant PVR were risk factors for poor visual outcomes. Lens capsule rupture was a risk factor for endophthalmitis development, and the administration of intravitreal antibiotic injection was a protective factor against endophthalmitis development.

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Section: Resultssupporting

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Intraocular Foreign Bodies: Clinical Characteristics and Factors Affecting Visual Outcome

Liang

Liu

et al. 2021

Journal of Ophthalmology

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“…In our previous study, we showed that the presence of IOFBs contributed to 21.4% of the rate of endophthalmitis [ 18 ]. IOFBs affect PTE prognosis in the following ways: (1) anatomical structure damage like PVR and retinal tear produced by IOFBs, (2) inflammatory chemistry of the IOFBs, and (3) carrier to deliver infectious agents [ 19 , 20 ]. Thus, we can conclude that the presence of IOFBs progresses the existing endophthalmitis and further adds difficulties to vitreous surgery, thereby contributing to worsening the prognosis.…”

Section: Discussionmentioning

confidence: 99%

Outcomes and Prognostic Factors of Posttraumatic Endophthalmitis: A Three-Year Retrospective Study

Zhong

et al. 2021

Journal of Ophthalmology

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Purpose. To describe the clinical features, management, and outcomes of patients with posttraumatic endophthalmitis (PTE) and to determine risk factors for poor visual prognosis. Methods. We retrospectively reviewed the medical records of 42 consecutive patients presenting with PTE who were treated at our institution between 2017 and 2019. Each patient’s data, including demographic characteristics, ocular injury details, surgical records, patient outcomes, and laboratory results, were collected and analyzed. Multivariate analysis was conducted to determine the factors associated with poor visual outcomes. Results. In our series, male (n = 36, 85.7%) and patients below 60 years of age (20–40 years, 23.8%; 40–60 years, 57.14%) comprised most of the total cohort. On presentation, 39 (92.8%) of the 42 PTE patients presented best-corrected visual acuity (BCVA) worse than counting fingers. Pars plana vitrectomy (PPV) was performed in all the patients. 59.5% (n = 25) of the patients’ BCVA improved after surgery and 33.3% (n = 14) achieved BCVA of 20/200 or better. The rate of evisceration was 7.1% (n = 3). Of the 42 specimens, the culture was positive in 10 (23.8%) eyes. By univariate analysis, factors including sex, occupation, systemic disease, source of trauma, lens injury, silicone oil tamponade, usage of intravitreal antibiotics, BCVA at presentation, and culture positive for any organism did not affect the final visual outcome. The features associated with poor BCVA (grouped as < 20/200 and ≥ 20/200) included older age ( P = 0.035 ), corneal-sclera wound (versus sclera wound) ( P = 0.047 ), retained intraocular foreign bodies (IOFBs) ( P = 0.006 ), treatment > 3 days (versus < 1 day) ( P = 0.033 ), and more times of surgeries ( P = 0.033 ). Conclusions. PTE is a severe complication of penetrating globe injuries associated with irreversible visual loss. Our results highlighted the importance of conducting early therapeutic PPV and IOFB removal to achieve better visual outcomes.

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“…Intraocular foreign bodies are significant ocular injuries. They typically require emergent removal and antibiotics to prevent endophthalmitis and retinal detachments; however, newer evidence does suggest delaying surgery does not increase the risk for endophthalmitis or retinal detachments 1 . Intraocular foreign bodies with minimal vitreous penetration may be able to be removed carefully without concomitant vitrectomy and still achieve good anatomic results.…”

Section: Figurementioning

confidence: 99%

Nail gun injury with intraocular foreign body

Starr

Cohen

2021

JACEP Open

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Clinical presentations and surgical outcomes of intraocular foreign body presenting to an ocular trauma unit

Cited by 17 publications

References 30 publications

Intraocular Foreign Bodies: Clinical Characteristics and Factors Affecting Visual Outcome

Intraocular Foreign Bodies: Clinical Characteristics and Factors Affecting Visual Outcome

Outcomes and Prognostic Factors of Posttraumatic Endophthalmitis: A Three-Year Retrospective Study

Nail gun injury with intraocular foreign body

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