Intraocular Foreign Bodies: Clinical Characteristics and Factors Affecting Visual Outcome

Abstract

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.

The Demographic and Social Characteristics of Patients with Ocular Foreign Bodies in a Greek Tertiary Hospital

“…The majority of the patients with OFBs were men (77%) with a mean age of 49.5 years. The predominance of male patients is consistent with the demographic characteristics of similar cases reported in previous studies, 5 , 24 , 25 simulating also the universal finding of reported male:female ocular injuries ratio of 7.8:1. 25 However, the mean age of men with OFBs in Greece presented slightly higher in comparison with data from other countries.…”

“…29 Moreover, a plausible explanation for the dominance of men is that they more frequently spend time outdoors, either for work or for other activities, such as sports; thus they are at higher risk of an ocular injury. 24 The vast majority of OFBs injuries (73.1%) occurred to persons with manual occupations, a finding which is in accordance with previous studies, which also have identified hammering as the most common cause worldwide. 5,24,[27][28][29] The great incidence of OFB injury cases raises questions about the implementation of precautionary measures in industry jobs and in cases of machine-tools use.…”

“… 29 Moreover, a plausible explanation for the dominance of men is that they more frequently spend time outdoors, either for work or for other activities, such as sports; thus they are at higher risk of an ocular injury. 24 …”

“…The vast majority of OFBs injuries (73.1%) occurred to persons with manual occupations, a finding which is in accordance with previous studies, which also have identified hammering as the most common cause worldwide. 5 , 24 , 27–29 The great incidence of OFB injury cases raises questions about the implementation of precautionary measures in industry jobs and in cases of machine-tools use. In the UK, employees in factories are reminded to wear eye protection through warning notices placed at work and most of the tools, especially hammers, have warning labels.…”

Outcomes and Prognostic Factors Following Pars Plana Vitrectomy for Intraocular Foreign Bodies—11-Year Retrospective Analysis in a Tertiary Care Center

“…Open globe injuries with retained IOFBs offer one of the most challenging scenarios to the ophthalmic surgeon due to their complex presentation. Previous studies have shown that the visual outcome in this type of ocular trauma is directly correlated with some predictive factors such as age, initial best corrected visual acuity (BCVA), wound length, IOFB size and the occurrence of complications such as retinal detachment (RD) and endophthalmitis [ 1 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. In this retrospective case series, we evaluated 56 patients with IOFBs who underwent pars plana vitrectomy (PPV) over an 11-year period, with the aim to outline the prognostic factors with an impact on the visual outcome.…”