Posterior Segment Intraocular Foreign Bodies: The Effect of Weight and Size, Early versus Late Vitrectomy, and Outcomes

Abstract

© 2015 TJTES. BACKGROUND: The objective of this study was to identify the effects of weight and size characteristics of posterior segment intraocular foreign bodies (IOFBs) in open globe injuries. METHODS: Fifty-eight eyes of 58 patients with posterior segment IOFBs were enrolled in the study. All IOFBs were removed by pars plana vitrectomy. Factors including age, gender, best corrected visual acuity (BCVA), nature of IOFBs, weight and dimensions of IOFBs, initial ocular features, timing of IOFB removal, entry site of IOFBs, interventions and complications were evaluated. RESULTS: Mean age of the patients was 32.7±14.2 years, and mean follow up period was 18±13.3 months. Weight, length, width and thickness of IOFBs were found negatively correlated with initial and final BCVA levels (p < 0.05). Weight of IOFBs was significantly greater in eyes with initial hyphema, vitreous hemorrhage, retinal hemorrhage, retinal detachment, and uveal prolapse (p < 0.05). Width and thickness of IOFBs were significantly greater in eyes with hyphema, vitreous hemorrhage, retinal hemorrhage and uveal prolapse (p < 0.05). Length of IOFBs was significantly longer in eyes with hyphema (p < 0.05). Presence of initial or subsequent retinal detachment was associated with poor final BCVA (p < 0.05). There was no association between the timing of IOFB removal and incidence of endophthalmitis. CONCLUSION: Greater weight and size of posterior segment IOFBs were associated with worse outcomes in open globe injuries. Protective eyewear has a crucial importance to avoid work-related injuries. In our study, early or late vitrectomy for an IOFB removal had no significant effect on anatomic and visual outcomes. Therefore, vitrectomy can be postponed until optimal conditions are obtained.