Clinical Characteristics and Prognostic Factors of Posterior Segment Intraocular Foreign Body: Canadian Experience from a Tertiary University Hospital in Quebec.

Jean-Philippe Rozon,Mélanie Hébert,Mathieu Caissie,Guillaume Lavertu,Ali Dirani,Eric Tourville,Eunice You,Serge Bourgault,Kannan Nb

doi:10.1155/2021/9990290

Abstract

Purpose To identify predictive factors for visual outcomes of patients presenting with a posterior segment intraocular foreign body (IOFB). Methods A retrospective chart review was performed for all consecutive patients operated for posterior segment IOFB removal between January 2009 and December 2018. Data were collected for patient demographics, clinical characteristics at presentation, IOFB characteristics, surgical procedures, and postoperative outcomes. A multiple logistic regression model was built for poor final visual acuity (VA) as an outcome (defined as final VA 50 letters or worse [Snellen equivalent: 20/100]). Results Fifty-four patients were included in our study. Ninety-three percent of patients were men, with a mean age of 40.4 ± 12.6 years. Metallic IOFB comprised 88% of cases with a mean ± standard deviation (SD) size of 5.31 ± 4.62 mm. VA improved in 70% of patients after IOFB removal. Predictive factors for poor VA outcome included poor baseline VA, larger IOFB size, high number of additional diagnoses, an anterior chamber extraction, a second intervention, the use of C3F8 or silicone tamponade, and the presence of vitreous hemorrhage, hyphema, and iris damage. Predictive factors for a better visual outcome included first intention intraocular lens (IOL) implantation and the use of air tamponade. In the multiple logistic regression model, both baseline VA (p = 0.009) and number of additional complications (p = 0.01) were independent risk factors for a poor final VA. Conclusions A high number of concomitant complications and poor baseline VA following posterior segment IOFB were significant predictive factors of poor visual outcome.

Highlights

Despite growing prevention efforts, ocular injuries remain a major cause of blindness with an estimated incidence of 2.4 million cases in the United States [1]
We investigated whether a high number of additional diagnoses were associated with weaker visual prognosis. is factor was determined in clinic by the sum of all diagnosis or complications among these of which the patient was affected: cataract, vitreous hemorrhage, hyphema, retinal detachment, retinal tears, iris damage, choroid detachment, and endophthalmitis
Forty-four percent of patients presented with an initial visual acuity (VA) of no light perception (NLP), light perception (LP), or hand motion (HM)

Summary

Introduction

Ocular injuries remain a major cause of blindness with an estimated incidence of 2.4 million cases in the United States [1]. E aim of this study is to identify predictive factors for visual outcomes of patients presenting with a posterior segment IOFB treated in a tertiary university hospital in Quebec, Canada, and to review the surrounding literature. Gender, VA preoperatively and at least one month after the last intervention, final diagnosis, IOFB characteristics (localization, size, nature, and entry site), and delay between the injury and the surgery in days. E following prognostic factors were analyzed for possible associations with final VA: age, time of injury to intervention, entry site, IOFB characteristics (i.e., location, size, nature), extraction site, clinical features on initial presentation (number of preoperative additional diagnoses, the presence of cataract, retinal tear, retinal detachment, vitreous hemorrhage, hyphema, iris damage, choroid detachment, endophthalmitis), IOL implantation (none, first or secondary implantation), the need for a secondary intervention (excluding phaco-IOL), and the need for a scleral buckle.

Results

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Discussion