Intraocular Foreign Bodies Impacted in the Posterior Segment of the Eye

Overview

Background:
A penetrating eye injury due to an intraocular foreign body (IOFB)may result in a poor vision and even in loss of the eye. A proper analysis of thecause of injury and of the injured eye enables a correct decision to be madeconcerning timing and method to be used not only for foreign body removal butalso concerning of all sight saving surgical procedures.Patients and methods: Over the years 1989 - 1993, 51 patients with an IOFB in theposterior segment of the eye were treated at the Department of Ophthalmologyof the Comenius University in Bratislava. One patient was lost from the long-termobservation and in two patients was an intraocular foreign body not removed. Weevaluate results in 48 patients. The operative techniques used by foreign bodyremoval and by reoperations are mentioned. The occurrence of peroperative andpostoperative complications and the final anatomical and functional results areevaluated. An average follow-up period was 40.7 months. The value of the followingprognostic factors was considered in relation to the final visual acuity: size and location of the laceration of the eye, size of IOFB and time of IOFB removal. Thestatistical significance was tested by Chí-square. Fischer’s coefficient for tetra-choric tables was used for the calculation of power of dependence.Results: The foreign body was removed from 64,6% of the eyes after pars-planavitrectomy. Foreign body caused serious damage of the intraocular structures in37,5 % of the eyes. The poor anatomical result was achieved in 18 (37.5%) and goodin 30 eyes (62.5%). In twelve eyes (25%) was implanted an IOL. The final visualacuity of 6/9 - 6/6 was achieved in 18 (37.5%) and visual acuity lower than 2/60 wasrecorded in 21 (43.7%) of the eyes. The prediction of bad visual acuity (lower than2/60) was significant related to: all lacerations except of corneal wounds smallerthan 4 mm, IOFB size exceeding 3x2 mm.Conclusions: Management of retained intraocular foreign bodies should be indi-vidual and is dependent on the extent of the initial injury and the characteristicsand location of the IOFB. The final outcome depends mostly on the extent of theprimary injury and of the occurence of the peroperative and postoperativecomplications.

Key words:
intraocular foreign body, posterior segment of the eye, prognosis