Vitrectomy for Posterior Segment Intraocular Foreign Bodies

Wani, Vivek B; Al-Ajmi, Mubarak; Thalib, Lukman; Azad, Rajavardhan V; Abul, Mohsen; Al-Ghanim, Munira; Sabti, Khaled

doi:10.1097/00006982-200310000-00008

Cited by 97 publications

(73 citation statements)

References 23 publications

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“…Good final visual outcome (VA of 20/40 or better) was reported in 30 to 71% of patients. 5,7,20 In this study, 36.4% of the patients had good final visual outcome, which demonstrated statistically significant correlation with the corneoscleral entry site (OR ¼ 18.36). The corneoscleral entry site indirectly reflected absence of retinal injury, which damaged the visual pathway, and absence of corneal scar that precluded good visual outcome.…”

Section: Discussionsupporting

confidence: 51%

Predictive factors and outcomes of posterior segment intraocular foreign bodies

Choovuthayakorn

Hansapinyo

Ittipunkul

et al. 2011

Eye

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Purpose To identify the predictive factors for anatomical and visual outcomes in posterior segment intraocular foreign body (IOFB) patients managed by pars plana vitrectomy (PPV). Methods A retrospective chart review was performed for 77 patients, who had PPV for IOFBs removal between January 2001 and July 2007. Univariate and multivariate analyses were conducted to evaluate the predictive factors.Results The mean age of the patients was 33.4 years. The nature of IOFBs was mainly metal, with injuries most commonly caused by an electric grass trimmer. The mean time interval between injury and IOFBs removal was 30.7 days. The mean preoperative visual acuity (VA) was 1.82 logarithm of the minimal angle of resolution (logMAR), and mean final was VA 1.10 logMAR. From multivariate analysis, good visual outcome was correlated with the corneoscleral entry site, and poor visual outcome was correlated with the presence of relative afferent pupillary defect. Conclusions In noncombat IOFBs, most cases were work-related. Delayed IOFBs removal was acceptable when primary wounds were repaired appropriately and extensive antibiotics administered. Even though advancement in vitreoretinal surgery can reduce the frequency of blindness, further promotion and education on eye protection during work are needed.

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Section: Discussionsupporting

confidence: 51%

Predictive factors and outcomes of posterior segment intraocular foreign bodies

Choovuthayakorn

Hansapinyo

Ittipunkul

et al. 2011

Eye

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“…[14][15][16][17] In the nonchorioretinectomy technique (PPV with endolaser surrounding the impact/exit wound and the edges of the retina and choroid were not removed), the PVR rates were between 62 and 89% and the visual and anatomic outcomes in these patients were extremely poor. [15][16][17] Pathologic findings have disclosed that PVR is the result of RPE proliferation and fibrous proliferation from the wound. 5,6 The chorioretinectomy technique, which was described first by Kuhn and co-workers, 18 was supposed to eliminate all the exposed RPE following a foreign body injury, as well as the fibrous proliferation around the perforation/impact site.…”

Section: Discussionmentioning

confidence: 99%

Chorioretinectomy for perforating eye injuries

Özdek

Hasanreisoğlu

Yüksel

2013

Eye

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Purpose To report the outcomes of chorioretinectomy in severe ocular injuries where a foreign body penetrated the choroid or perforated the globe. Methods The study sample consisted of a retrospective, non-comparative, consecutive interventional case series of 13 perforating or severe intraocular foreign body ocular injuries that were treated at a single institution from March 2008 to March 2010. All the patients were operated with 20-gauge three-port pars plana vitrectomy (PPV) by removing the choroid and/or retina with scar tissue at the perforation site of the foreign body. The reports of patients were examined for best-corrected visual acuity, globe survival, retinal detachment status, and proliferative vitreoretinopathy. Results A total of 13 eyes of 13 patients with a mean age of 25.8 ± 9.0 years (range, 11-38 years) were followed for a median of 13.8±5.4 months (range, 8-29 months). The mean time period between injury and the vitreoretinal surgery was 13.6±9.3 days. All had an exit/impact site wound, eight of which were located in the posterior pole, which caused choroidal and retinal incarceration in the macular area. PPV together with chorioretinectomy, endolaser applications, silicone oil tamponade, with/ without encircling band, and lensectomy surgery was applied to all of them. Final best-corrected visual acuity (BCVA) Z20/200 occurred in 4 of 13 (30.76%) patients. Globe survival rates were 100% (13 of 13), and final retinal attachment rate was 84.6% (11 of 13). The proliferative vitreoretinopathy rate was 2 of 13 (15.3%). Conclusion Chorioretinectomy is a surgical option that may decrease post-traumatic proliferative vitreoretinopathy and tractional retinal detachment rates, thus improving final BCVA and increasing globe survival rates when a foreign body penetrates the choroid and perforates the globe.

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“…Many of these factors have previously been reported, [6][7][8]10,13,14 and indicate that severe initial damage is strongly predictive of poor visual outcome. Interestingly, removal of IOFB within 24 h of presentation, RAPD in injured eye at presentation, and IOFB involving the posterior segment were not found to be significant factors for a poor visual outcome.…”

Section: Discussionmentioning

confidence: 99%

“…These include large diameter of IOFB, poor visual acuity on presentation, relative afferent pupil defect (RAPD) on presentation, corneoscleral entry wound, uveal prolapse, vitreous haemorrhage, and presence of a secondary retinal detachment. [6][7][8]10,13,14 The study aimed to determine whether the final visual outcome had improved compared to previous reports and whether previously identified prognostic factors remained predictive of a poor outcome.…”

Section: Introductionmentioning

confidence: 99%

Surveillance of intraocular foreign bodies in the UK

Imrie

Cox

Foot

et al. 2007

Eye

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Aims To estimate the incidence of penetrating injuries with retained intraocular foreign bodies (IOFBs) in the United Kingdom, and to provide epidemiological data on the aetiology, management, and visual outcome of such injuries. Methods Cases were identified prospectively by active surveillance through the British Ophthalmological Surveillance Unit reporting card system, for the 12-month period June 2004 to May 2005 inclusive. Questionnaire data were obtained from UK ophthalmologists at presentation and 6 months following presentation. Results Data were available on 97 patients at presentation and 95 patients at follow-up. The minimum estimated incidence of IOFBs in the United Kingdom identified in this study was 0.16 per 100 000. All patients were male. Hammering was the most common mechanism of injury, occurring in 62% of patients. The IOFB was found in the anterior segment in 24%, the posterior segment in 73%, and involved both segments in 3%. Endophthalmitis was diagnosed in 9% of patients. Best-corrected visual acuity of the injured eye at final follow-up was 6/12 or better in 67%, 6/18 to 6/60 in 11%, and worse than 6/60 in 22%. Prognostic factors for a poor visual outcome included poor visual acuity at presentation, prolapse of intraocular tissue, development of endophthalmitis, development of retinal detachment, and large size of IOFB. Conclusions The incidence of IOFB in the United Kingdom appears to have reduced compared to previous studies. The majority of patients (67%) retain good visual acuity in the injured eye; however, a significant minority (22%) sustain long-term severe visual loss.

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Vitrectomy for Posterior Segment Intraocular Foreign Bodies

Cited by 97 publications

References 23 publications

Predictive factors and outcomes of posterior segment intraocular foreign bodies

Predictive factors and outcomes of posterior segment intraocular foreign bodies

Chorioretinectomy for perforating eye injuries

Surveillance of intraocular foreign bodies in the UK

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