Clinical presentations and surgical outcomes of intraocular foreign body presenting to an ocular trauma unit

Graefes Arch Clin Exp Ophthalmol. 2021 Jan;259(1):263-268. doi: 10.1007/s00417-020-04859-6. Epub 2020 Jul 30.

Abstract

Objectives: To describe, evaluate, and identify the characteristics, prognostic factors, and visual outcomes in patients with intraocular foreign body (IOFB) in a Latin American population.

Methods: A retrospective, observational case-series of patients with a diagnosis of IOFB. Variables analyzed included age, gender, initial and final best correct visual acuity (BCVA), ocular trauma score, intraocular pressure, mechanism of injury, material and number of IOFB, zone of injury, timing of primary repair and IOFB removal, complications, and follow up.

Results: Sixty-one patients with IOFB were identified of which 97% were male with a mean age of 37.9 years (SD 2.16). The most common IOFB location was intravitreal (43%). IOFBs were metallic in 78%, vegetal in 3%, and other materials in 11%. Primary repair and secondary IOFB removal were performed at a mean timepoint of 3 days and 5 days, respectively. Systemic and topical antibiotics were administered to all patients. The initial BCVA was 1.62 logMAR and the final was 0.6 logMAR, which was statistically significant (Pearson's chi-squared test, p value 0.01). No cases of endophthalmitis were seen.

Conclusion: IOFB removal can be delayed when there are no signs of infection or evidence of retinal detachment, without an increased risk of endophthalmitis and a negative impact on visual outcomes. Use of topical and systemic antibiotics appear sufficient to prevent endophthalmitis in these cases.

Keywords: Antibiotics; Intraocular foreign body; Latin America; Ocular trauma; Retina; Traumatic endophthalmitis; Traumatic retinal detachment; Vitreoretinal surgery.

MeSH terms

  • Eye Foreign Bodies* / diagnosis
  • Eye Foreign Bodies* / surgery
  • Eye Injuries, Penetrating* / diagnosis
  • Eye Injuries, Penetrating* / surgery
  • Humans
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Trauma Centers
  • Treatment Outcome
  • Vitrectomy