Comparison of efficacy of 23 G vitrectomy through limbal corneal incision or scleral incision for the extraction of intraocular foreign body

Abstract

Objective To compare the clinical effects and safety of 23 G vitrectomy through limbal corneal incision or scleral incision for the extraction of posterior segment intraocular foreign bodies. Methods Thirty-four eyes of 34 patients who underwent 23 G vitrectomy for the extraction of posterior segment intraocular foreign body were randomly divided into two groups. Scleral incision was made to extract the foreign body in group A. Limbal corneal incision was made in group B. The prolapse rate of uvea and vitreous and the difficulty of extraction of intraocular foreign bodies by two surgical ways were compared. The follow up time was 3~12 months. The retinal detachment rate, intraocular pressure, visual acuity and corneal endothelial cells were analyzed postoperatively. Results All foreign bodies were successfully removed. Vitreous and uvea prolapse happened in 3 cases and foreign bodies dropped and caused the damage of posterior retina in 2 cases in group A when the sclera incision was enlarged during the surgery, while no one happened in group B. During the follow-up of 3~12 months, the visual acuity was improved postoperatively and no endophthalmitis happened. Retinal detachment occured in 1 case in group A and the retinal reattachment operation was performed again. The difference in intraocular pressure, corneal endothelial cell counting between two groups was not statistically significant. Conclusion 23 G vitrectomy through limbal corneal incision or scleral incision for the extraction of posterior segment intraocular foreign body all are safe and effective. It can avoid secondary injury of cornea and lens and maintain anterior chamber stability when through scleral incision, while it can avoid uvea and vitreous prolapse and the foreign body dropping during the surgery due to the lens capsule and iris, and get clear way out through limbal corneal incision, which is a safer and more effective way especially for posterior segment intraocular foreign bodies extraction. Key words: Foreign bodies, intraocular, posterior segment; Vitrectomy; Extraction, foreign bodies