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Intraocular foreign bodies extracted by pars plana vitrectomy: clinical characteristics, management, outcomes and prognostic factors.

Nicoară SD, Irimescu I, Călinici T, Cristian C - BMC Ophthalmol (2015)

Bottom Line: The visual outcome was significantly worse in patients with RD at presentation (p = 0.012) and with IOFBs larger than 3 mm (p = 0.042).Endophthalmitis did not influence the visual outcome.IRCT2015040418966N3 / Apr. 9/2015.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 8, V. Babeș str, 400012, Cluj-Napoca, Romania. simonanicoara1@gmail.com.

ABSTRACT

Background: Intraocular foreign bodies (IOFBs) are an important cause of visual loss within the group of working age population. We aim to present the clinical features and the algorithm according to which we manage the foreign bodies that are located in the posterior segment of the eye. We define the outcomes and the prognostic factors that influenced the final visual acuity and globe survival in patients with IOFBs that we extracted by pars plana vitrectomy (PPV) over a 5-year period.

Methods: We reviewed the medical records of all the cases with IOFBs that we removed by PPV, over 5 years (2009-2013). We extracted the following parameters: age, gender, wound anatomy, IOFB characteristics, ocular lesions, initial and final visual acuities. We used the program SPSS version 20.0.0. for the statistical analysis of our data.

Results: During 5 years, we treated 21 IOFBs by PPV, representing 12.20 % of all the open globe injuries. All the patients were males with the median age of 36 years. The foreign body was located in the vitreous - 11 cases (52.38 %), retina - seven cases (33.33 %) and perforating - three cases (14.28 %). Retinal detachment (RD) at presentation was identified in eight cases (38.09 %) and endophthalmitis, in six cases (28.57 %). The visual outcome was significantly worse in patients with RD at presentation (p = 0.012) and with IOFBs larger than 3 mm (p = 0.042). Endophthalmitis did not influence the visual outcome.

Conclusions: The worse prognostic factors were: RD at presentation and large foreign body.

Trial registration number: IRCT2015040418966N3 / Apr. 9/2015.

No MeSH data available.


Related in: MedlinePlus

IOFB approach with the intraocular magnet
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Fig1: IOFB approach with the intraocular magnet

Mentions: PPV was carried out in all cases within 24 h from admission in our hospital, in 11 cases we used 20G vitrectomy and in ten cases, 25G vitrectomy. Of the 21 foreign bodies, three were perforating. The exit wounds were larger than the entrance ones and located as follows: transfoveal (case 8), nasally to the optic disc (case 16) and inferior, in the mid periphery of the retina (case 17). In all these three circumstances, the IOFBs were left in the orbit. Retinal detachment was associated in all the three cases and it was treated on the same session. The remaining 18 IOFBs were all metallic and magnetic. After having completed the vitrectomy and released the IOFB from the adherences with the vitreous and the retina, we enlarged one sclerotomy and extracted the IOFB with the intraocular magnet (Figs. 1 and 2).Fig. 1


Intraocular foreign bodies extracted by pars plana vitrectomy: clinical characteristics, management, outcomes and prognostic factors.

Nicoară SD, Irimescu I, Călinici T, Cristian C - BMC Ophthalmol (2015)

IOFB approach with the intraocular magnet
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4631100&req=5

Fig1: IOFB approach with the intraocular magnet
Mentions: PPV was carried out in all cases within 24 h from admission in our hospital, in 11 cases we used 20G vitrectomy and in ten cases, 25G vitrectomy. Of the 21 foreign bodies, three were perforating. The exit wounds were larger than the entrance ones and located as follows: transfoveal (case 8), nasally to the optic disc (case 16) and inferior, in the mid periphery of the retina (case 17). In all these three circumstances, the IOFBs were left in the orbit. Retinal detachment was associated in all the three cases and it was treated on the same session. The remaining 18 IOFBs were all metallic and magnetic. After having completed the vitrectomy and released the IOFB from the adherences with the vitreous and the retina, we enlarged one sclerotomy and extracted the IOFB with the intraocular magnet (Figs. 1 and 2).Fig. 1

Bottom Line: The visual outcome was significantly worse in patients with RD at presentation (p = 0.012) and with IOFBs larger than 3 mm (p = 0.042).Endophthalmitis did not influence the visual outcome.IRCT2015040418966N3 / Apr. 9/2015.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 8, V. Babeș str, 400012, Cluj-Napoca, Romania. simonanicoara1@gmail.com.

ABSTRACT

Background: Intraocular foreign bodies (IOFBs) are an important cause of visual loss within the group of working age population. We aim to present the clinical features and the algorithm according to which we manage the foreign bodies that are located in the posterior segment of the eye. We define the outcomes and the prognostic factors that influenced the final visual acuity and globe survival in patients with IOFBs that we extracted by pars plana vitrectomy (PPV) over a 5-year period.

Methods: We reviewed the medical records of all the cases with IOFBs that we removed by PPV, over 5 years (2009-2013). We extracted the following parameters: age, gender, wound anatomy, IOFB characteristics, ocular lesions, initial and final visual acuities. We used the program SPSS version 20.0.0. for the statistical analysis of our data.

Results: During 5 years, we treated 21 IOFBs by PPV, representing 12.20 % of all the open globe injuries. All the patients were males with the median age of 36 years. The foreign body was located in the vitreous - 11 cases (52.38 %), retina - seven cases (33.33 %) and perforating - three cases (14.28 %). Retinal detachment (RD) at presentation was identified in eight cases (38.09 %) and endophthalmitis, in six cases (28.57 %). The visual outcome was significantly worse in patients with RD at presentation (p = 0.012) and with IOFBs larger than 3 mm (p = 0.042). Endophthalmitis did not influence the visual outcome.

Conclusions: The worse prognostic factors were: RD at presentation and large foreign body.

Trial registration number: IRCT2015040418966N3 / Apr. 9/2015.

No MeSH data available.


Related in: MedlinePlus