Prognosis of penetrating eye injuries with posterior segment intraocular foreign body

Graefes Arch Clin Exp Ophthalmol. 2008 Jan;246(1):161-5. doi: 10.1007/s00417-007-0650-1. Epub 2007 Aug 4.

Abstract

Purpose: To identify the prognostic factors concerning the anatomy and visual acuity of eyes subject to trauma related posterior intraocular foreign body.

Patients and methods: The records of 28 eyes of 27 patients who underwent pars plana vitrectomy and intraocular foreign body removal during a 5 year period were retrospectively reviewed. Ocular trauma score was calculated for each eye.

Results: The most common initial findings were corneal wound (68%), lens injury (50%), retinal lesion (50%), vitreous hemorrhage (25%), and endophthalmitis (14%). Multiple foreign body causing perforating injury with retained posterior segment foreign body occurred in 7% of the cases. The foreign body was found on the surface of the retina in 39% of the cases. Postoperative complications were retinal detachment (46%), proliferative vitreoretinopathy (25%), and phthysis (4%). No eye was enucleated and 1 eye (4%) lost light perception. The final best corrected visual acuity became better or equal to 0.5 Snellen E in 34% of the eyes. The mean follow-up was 19 months (1.5-60 months).

Conclusions: Prognosis was significantly worse in cases with lower trauma score, initial visual acuity less than 0.1 Snellen E, large foreign body, upset of bacterial endophthalmitis, and with proliferative vitreo-retinopathy. Visual outcomes in our cases were better than estimated follow-up visual acuity based on ocular trauma score parameters.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Corneal Injuries
  • Endophthalmitis / diagnosis
  • Eye Foreign Bodies / classification
  • Eye Foreign Bodies / diagnosis*
  • Eye Foreign Bodies / surgery
  • Eye Injuries, Penetrating / classification
  • Eye Injuries, Penetrating / diagnosis*
  • Eye Injuries, Penetrating / surgery
  • Humans
  • Lens, Crystalline / injuries
  • Male
  • Middle Aged
  • Prognosis
  • Retina / injuries*
  • Retrospective Studies
  • Risk Factors
  • Trauma Severity Indices
  • Visual Acuity
  • Vitrectomy
  • Vitreous Hemorrhage / diagnosis