23 Gauge pars plana vitrectomy for the removal of retained intraocular foreign bodies

Abstract

Background: To evaluate the morpho-functional outcomes and safety of transconjuctival 23-gauge pars plana vitrectomy(PPV) for removal of intraocular foreign bodies (IOFBs). Methods: A retrospective study of 36 consecutive cases (mean age; 34,2∈±∈10,9 years (between 15 and 60), 27 M,9 F) of 23-G PPV for the removal of IOFBs during the period of April 2009 and December 2011 and followed 9,4∈±∈6,4(2-27) months were conducted. Visual outcomes, slit lamp biomicroscopy, intraocular pressure (IOP), and posterior segment visualization by indirect ophthalmoscopy, A-B mode ultrasonography, and computed orbital tomography were performed for all cases. Main outcomes including anatomic and visual outcomes, and both intraoperative and postoperative complications were recorded. Results: Of the 36 cases available for the study, the IOFBs (size range, 3 to 12 mm) could be removed in all eyes. Mean preoperative LogMAR BCVA was 1.44∈±∈138 (range, 1.00 to 0.00) and mean postoperative LogMAR BCVA at final visit was 0,78∈±∈0,98 (range, 1.00 to 0.00). (P∈=∈0,007) Anatomic success was obtained in 97.2 % of eyes. 16 patients needed primary wound repair due to the leakage in insertion sites before the PPV, however remaining 20 cases were not. Fibrin reaction was seen in 8 (22.2 %) patients in early postoperative period, intraocular pressure elevation was detected in 12 (33.3 %) patients in which the silicone oil was used as an intravitreal tamponade, one patient with silicone oil tamponade developed band keratopathy and phthisis bulbi. Conclusions: 23-Gauge PPV is a feasible, effective approach in the surgical management of the patients with posterior segment intraocular foreign bodies.