Artikel
Prognostic factors of posterior segment intraocular foreign body – our experience
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Veröffentlicht: | 18. Juni 2008 |
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Purpose: To evaluate the main factors related to visual outcome after removal of posterior segment intraocular foreign body (IOFB) by pars plana vitrectomy.
Methods: A retrospective study of 20 consecutive cases of pars plana vitrectomy for removal of IOFBs during the period of January 2004 to December 2007 was conducted. Association between visual outcome and various preoperative, operative, and postoperative variables was statistically analyzed. All cases had a minimum follow-up of 6 months.
Results: all except one were male with a median age of 46. 40% of trauma occurred at work and 35% at home. In 30%, the wound location involved the sclera. The preoperative BCVA was between light perception and hand movement in 85%. Removal of IOFB was managed at primary surgery in 80% of cases by forceps within 2 days of the injury; the others 20% were managed in a secondary procedure. At primary surgery it was found 10% of retinal detachment (2 eyes), 15% of endophthalmitis (3 eyes),and 40% of retinal tears (8 eyes). Ten patients (50%) achieved a visual acuity of 20/40 or better. During all follow-up, 30% had retinal detachment (2/3 managed final BCVA of 20/40 or better), and 10%, corneal alterations associated with silicone oil. Poor visual outcome was found to be significantly associated with the length of the laceration, the elapsed time between the injury and the surgery, the presence or absence of vitreous loss, cataract (lens damage), hyphema, laceration posterior to rectus muscle insertion and retinal detachment.
Conclusions: In this study, endophthalmitis occurred in 20% of cases and retinal detachment in 30%. Although development of retinal detachment, 2/3 obtained good visual acuity. Main prognostic factors for visual outcome might be the occurrence of endophthalmitis, corneal alterations and retinal detachment.