Long-term ophthalmic anatomical and functional outcomes after surgical removal of intraorbital foreign bodies

Mehta, Aditi; Singh, Manpreet; Yadav, Deepti; Kaur, Manpreet; Singh, Jyoti; Sharma, Manorma; Zadeng, Zoramthara; Gupta, Pankaj

doi:10.1177/1120672119885587

Cited by 5 publications

(9 citation statements)

References 19 publications

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“…Intraorbital foreign bodies (IOFBs) are severe and complicated ocular trauma, constituting 16.7% of orbital injuries ( 1 , 2 ). It is defined as the foreign bodies located in the orbital cavity, behind the orbital septum and the eyeball ( 3 ), which can cause damage to vision, eyeball, optic nerve, vasculature, and extraocular muscles ( 4 , 5 ). Besides, IOFBs can cause chemical toxicity and microbial infection ( 6 ) and invade extra orbital tissue ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

“…Compared with other foreign bodies, the diagnosis of intraorbital wooden foreign bodies (IOWFBs) can be particularly difficult due to the limitations of medical history and external signs, as well as the initial negative performance of CT ( 9 ). As a result, IOWFBs may be overlooked in the initial stage of injury, resulting in severe orbital tissue necrosis and intraorbital infection, such as orbital cellulitis, abscess formation, and orbital fistula ( 4 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

“…In practice, IOFBs and surgical approaches may affect visual function, eye movement, and appearances, such as proptosis, enophthalmos, and eyelid malformations. Therefore, it has been recommended to pay particular attention to the protection of the optic nerve, extraocular muscles, and other vascular and soft tissues, which could be beneficial for retaining vision, eye movement, and other ocular functions ( 4 , 10 ). Nonetheless, due to the negative CT performance and fragility of some special IOFBs, especially IOWFBs, missed diagnosis and residual often happen during the initial surgery.…”

Section: Introductionmentioning

confidence: 99%

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Clinical analysis of 96 patients with intraorbital foreign bodies: A 10-year retrospective study

You

Wang²,

Cheng³

et al. 2022

Front. Med.

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IntroductionTo investigate the clinical manifestations, diagnosis, and surgical treatment of intraorbital foreign bodies (IOFBs).MethodsPatients with IOFBs were enrolled from Wuhan Union Hospital between January 2011 and January 2021. Demographic and clinical information was extracted, including gender, age, cause and entrance of the trauma, material, size and quantity of foreign body, visual function, ocular complications, imaging findings, and surgical intervention. The patients were divided into two groups according to the timeline, group A (from January 2011 to December 2015, n = 39) and group B (from January 2016 to January 2021, n = 57).ResultsThe 96 patients (81 men and 15 women) were enrolled in this series, with a median age of 39.5 (1.6–76.0) years. Work-related injuries were the cause of IOFBs in 45 individuals (46.9%). Three patients (3.3%) presented severe visual impairment, and 39 patients (42.4%) presented blindness. The majority of foreign bodies were metal (44.8%), followed by wood (26.0%). Computed tomography (CT) and magnetic resonance imaging (MRI) were performed, respectively, on 89 (92.7%) and 21 (21.9%) patients with IOFBs, in which the detection rate was 80.9% for CT and 81.0% for MRI. Among the 25 patients with intraorbital wooden foreign bodies (IOWFBs), the utilization and detection rates of MRI were 50.0% and 40.0% in group A, and 93.3% and 92.9% in group B, with significant differences in both rates between the two groups (both P < 0.05). The IOWFBs detection rate in MRI was significantly higher than that in CT (78.9% vs. 45.8% overall and 92.9% vs. 53.5% in group B). The detection rates of IOFBs and IOWFBs in initial surgery were statistically different between the two groups, of which the rates were 84.6% and 40.0% in group A and 98.2% and 93.3% in group B. The reoperation rate of IOWFBs in group B (20.0%) was significantly lower than that in group A (70.0%).ConclusionIOFBs were mainly caused by work-related injuries and might lead to serious visual impairment. The application and detectability of MRI in IOWFBs improved in recent years, and MRI presented better detectability than CT in diagnosing IOWFBs. Thus, MRI should be recommended despite negative CT findings.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical analysis of 96 patients with intraorbital foreign bodies: A 10-year retrospective study

You

Wang²,

Cheng³

et al. 2022

Front. Med.

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“…I ntraorbital foreign bodies (IOFBs) are typically caused by a high-velocity trauma to the orbit but may also occur after relatively trivial trauma [1] , constitute 16.7% of orbital injuries [2][3][4] . While most IOFBs are metallic or glass particles, intraorbital wooden foreign bodies (IOWFBs) are relatively rare [5] .…”

Section: Introductionmentioning

confidence: 99%

“…The diagnosis of IOWFBs is sometimes difficult due to insufficient information regarding history of trauma, as well as the insufficiency in the external signs. In addition, radiologic diagnosis of IOWFBs is always uncertain and quite difficult, because the low density of IOWFBs is similar to air and adipose tissue on initial computed tomography (CT) [4] . Therefore, IOWFBs are frequently omitted and may not be confirmed until days or months after the initial injury.…”

Section: Introductionmentioning

confidence: 99%

Intraorbital wooden foreign bodies: case series and literature review

et al. 2021

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Intraorbital wooden foreign bodies (IOWFBs) constitute a relatively rare ocular trauma, which occupy a special type of intraorbital foreign bodies (IOFBs). Data regarding IOWFBs must be obtained from case reports or small case series due to their rarity. Here, we reported 5 cases of IOWFBs and reviewed the related literatures, which could provide comprehensive information regarding the clinical manifestations, diagnosis, and surgical treatment of IOWFBs. Combined with the published literature, a total of 51 independent cases were counted after we added 5 cases. Among them, the number of male and female patients was 35 and 16 respectively; the mean age was 27.3±18.2 (range 1-66)y. Obviously, the disorder seemed to occur mainly in young and middle-aged people. Because of the diversity in the clinical manifestations and imaging characteristics of IOWFBs, misdiagnosis and missed diagnosis often occur during the initial visit. Delayed diagnosis may lead to a high risk of orbital infection caused by IOWFBs. Surgery is the treatment of choice for most patients; however, the missed diagnosis and residue of foreign bodies after previous surgery cannot be ignored. Therefore, an accurate diagnosis is governed by the detailed trauma history, careful ocular examination, close observation of clinical manifestations, correct imaging diagnosis [e.g., magnetic resonance imaging (MRI) or computerized tomography (CT)], and timely and completely elimination of IOWFBs.

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