Intraocular foreign bodies extracted by pars plana vitrectomy: clinical characteristics, management, outcomes and prognostic factors

Nicoară, Simona Delia; Irimescu, Iulian; Călinici, Tudor; Cristian, Cristina

doi:10.1186/s12886-015-0128-6

Cited by 47 publications

(65 citation statements)

References 25 publications

(37 reference statements)

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“…The majority of patients were working adults (84.7%) and males (97.2%), and similar findings are found world-wide in studies of ocular trauma 1,[9][10][11][12] . The time lapse between injury and admission to hospital varied from 1 to 10 days, however this parameter alone did not affect the final visual acuity.…”

Section: Discussionsupporting

confidence: 81%

“…Patients with retinal detachment at presentation, had a significantly lower postoperative BCVA. This was confirmed in the study of Lin et al 13 and Nicoara et al 10 , although other authors found no correlation 1,8 . The occurrence of retinal detachment was not affected by the time lapse between the injury and admission, localization of the wound, size or localization of IOFB, presence of iris injury or endophthalmitis.…”

Section: Discussionmentioning

confidence: 57%

“…Since our study included only penetrating eye injuries with IOFB retained in the posterior segment of the eye, a slightly higher rate of posttraumatic endophthalmitis was observed (15.3%), when compared to other studies that included both anterior and posterior segment injuries 16 . However, in study of Nicoara et al, considerably higher incidence of posttraumatic endophthalmitis (28.6%) was noted 10 .…”

Section: Discussionmentioning

confidence: 84%

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Clinical characteristics of posterior segment penetrating eye injuries treated in tertiary referral hospital in Serbia

et al. 2020

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Background/Aim. Ocular trauma is a significant cause of visual impairment worldwide. The aim of the study was to analyze clinical characteristics of patients with penetrating eye injuries with retained intraocular foreign body (IOFB) in posterior segment of the eye. Methods. The medical records of consecutive patients hospitalized in a five year period (2012.-2016.) in a tertiary referral center in Serbia, were retrospectively analyzed. Surgical repair included pars plana vitrectomy and IOFB removal. Postoperative results were evaluated using the best corrected visual acuity (BCVA). Results. Out of 130 patients who suffered penetrating eye injury with retained IOFB, 72 had IOFB in posterior segment of the eye (43 in retina, 25 in vitreous, 3 in ciliary body, 1 on the optic nerve). Patients were predominantly young adults (aged 44.3±14.9 years, 97.2% men). Average BCVA at admission was poor (0.27±0.38, measured by Snellen chart), and 52.8% of patients had BCVA of counting fingers at 1 meter or less. The majority of patients had corneal wound (70.8%), medium sized IOFB (48.6%), iris injury (61.1%) and traumatic cataract (69.4%). Complications included retinal detachment (16.7%) and endophthalmitis (15.3%). Two patients had the eye enucleated due to severe endophthalmitis, which could not be otherwise controlled. Significant factors for postoperative outcome were: initial BCVA (p<0.001), ocular hypotony (p=0.013), small size of IOFB (p=0.037), presence of traumatic cataract (p=0.036), retinal detachment (p=0.032) and endophthalmitis (p=0.045). Conclusion Treatment of posterior segment penetrating eye injuries remains a challenge, due to high frequency of low initial visual acuity, retinal detachment and endophthalmitis, all of which are risk factors for poor visual outcome. Patients with better initial BCVA, normal intraocular pressure and small IOFB have better postoperative results. Key words: intraocular foreign body, penetrating eye injury, retinal detachment, posttraumatic endophthalmitis.Apstrakt Uvod/Cilj. Trauma oka predstavlja značajan uzrok vidne nesposobnosti širom sveta. Cilj studije bio je ispitati kliničke karakteristike pacijenata sa penetrantnim povredama oka sa zadržanim stranim telom u zadnjem segmentu oka. Metode. Medicinska dokumentacija konsekutivnih pacijenata hospitalizovanih tokom petogodišnjeg perioda (2012.-2016.) u tercijernom zdravstvenom centru u Srbiji, je retrospetkivno analizirana. Hirurške procedure su obuhvatale pars plana vitrektomiju i uklanjanje stranog tela. Postoperativni rezultati su procenjivani pomoću najbolje korigovane vidne oštrine. Rezultati. Od ukupno 130 pacijenata koji su pretrpeli penetrantnu povredu oka sa zadržanim intraokularnim stranim

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 84%

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Clinical characteristics of posterior segment penetrating eye injuries treated in tertiary referral hospital in Serbia

et al. 2020

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“…Posterior segment metallic intraocular foreign bodies (IOFBs) are one of leading causes of visual morbidity and blindness, especially among the young and middleaged working populations [1,2]. They present very distinct surgical challenges since these objects travel at high speeds serially through the ocular organs, moving from the cornea into the lens and, vitreous cavity and finally impacting the retina.…”

Section: Introductionmentioning

confidence: 99%

Surgical outcomes of the removal of posterior segment metallic intraocular foreign bodies

et al. 2020

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Background: Posterior segment metallic intraocular foreign bodies (IOFBs) are a leading cause of visual morbidity and blindness, especially among young and middle-aged working populations. Here, we aimed to evaluate the surgical outcomes of the removal of such IOFBs that result from injuries. Methods: In this retrospective study, 39 patients injured by metallic posterior segment IOFBs and who underwent primary repair procedures, vitrectomies, and IOFBs removal with or without procedures for traumatic cataract removal, scleral buckling and intraoperative tamponade application from January, 2008 to January, 2019. We analyzed the preoperative, intraoperative and postoperative related factors that affect the final visual outcomes. Results: The mean age of the 39 patients was 40.51 ± 12.48 years with the male being predominent (100%).The mean preoperative vision measured 1.50 [Snellen Equivalent (SE), 20/645] ± 1.12 logMAR with the mean final vision measuring 0.93 (SE, 20/172) ± 1.09 logMAR. The related factors that were determined to affect the final visual outcomes included preoperative vision (P = 0.025), IOFB-related macula injuries (P = 0.001) and the development of postoperative complications (P = 0.005) especially retinal detachment (P = 0.002) with the mean final vision measuring 2.12 (SE, counting finger to hand motion) ±1.23 logMAR. Concerning the preoperative signs, the patients with preoperative endophthalmitis also obtained poor mean final vision measuring 1.30 (SE,20/400) ± 1.40 logMAR. Conclusion: IOFB-related macula injuries and postoperative retinal detachment were important related factors of poor final visual prognoses in cases involving posterior segment metallic IOFBs. Removing IOFB as early as possible may prevent preoperative endophthalmitis which could lead poor final visions even without significance.

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“…The advancement in microsurgical vitreoretinal surgery techniques and instrumentation has allowed managing successfully traumatized eyes with IOFBs [7, 8]. In very few reports 25-gauge vitrectomy surgery was successfully used for the removal of foreign bodies and to manage ocular lesions using different maneuvers [9–11]. In this case series we report our experience in treating open eye injuries with IOFBs by 25-gauge pars plana vitrectomy in order to evaluate the final visual acuity, globe survival, and complication rate and to describe the proceedings of IOFBs removal and the management of ocular lesions correlated.…”

Section: Introductionmentioning

confidence: 99%

25-Gauge Vitrectomy in Open Eye Injury with Retained Foreign Body

Sborgia

Recchimurzo

Niro

et al. 2017

Journal of Ophthalmology

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Purpose. Ocular trauma with retained foreign body is an important cause of visual impairment in working-age population. Clinical status impacts on the timing and planning of surgery. In the last year small gauge vitrectomy has become safer and more efficient, extending the range of pathologies successfully treated. Aims. To evaluate the safety and outcomes in patients with open eye injury with retained foreign body that underwent early 25-gauge vitrectomy. Methods. In this retrospective, noncomparative, interventional case series, we performed 25-gauge vitrectomy on 10 patients affected by open globe injuries with retained foreign body, over 3 years. We analyzed age, wound site, foreign body characteristics, ocular lesions correlated, relative afferent pupillary defect, visual acuity, and intraocular pressure. Follow-up evaluations were performed at 1, 3, and 6 months. According to the clinical status we performed other procedures to manage ocular correlated lesions. Results. The median age of patients was 37 years. The foreign body median size was 3.5 mm (size range, 1 to 10 mm). 25-gauge vitrectomy was performed within 12 hours of trauma. Foreign body removal occurred via a clear corneal or scleral tunnel incision or linear pars plana scleral access. Visual acuity improved in all patients. Endophthalmitis was never reported. Only two cases reported postoperative ocular hypertension resolved within the follow-up. Retinal detachment recurred in one case only. Conclusions. 25-gauge vitrectomy could be considered as early approach to manage open globe injuries with a retained posterior segment foreign body in selected cases with good outcomes and low complication rate.

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Intraocular foreign bodies extracted by pars plana vitrectomy: clinical characteristics, management, outcomes and prognostic factors

Cited by 47 publications

References 25 publications

Clinical characteristics of posterior segment penetrating eye injuries treated in tertiary referral hospital in Serbia

Clinical characteristics of posterior segment penetrating eye injuries treated in tertiary referral hospital in Serbia

Surgical outcomes of the removal of posterior segment metallic intraocular foreign bodies

25-Gauge Vitrectomy in Open Eye Injury with Retained Foreign Body

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