Abstract
Aim To describe epidemiologic and clinical characteristics and prognostic factors influencing visual outcome after intraocular foreign bodies (IOFBs) injury. Methods Medical records of 370 patients (373 eyes) with IOFBs were reviewed to identify the factors influencing visual acuity by univariate and multivariate analyses. Results The majority of patients (97.0%) were men, with a mean age of 38.1 years. The most common cause of ocular injury was hammering (52.6%); magnetic IOFBs occurred in 84.7% of these cases. Factors associated with poor visual outcome (defined as <1.3 logMAR) included the following: age ≥50 years (P=0.046); worse presenting visual acuity (P < 0.001); complications of retinal breaks (P=0.006) and endophthalmitis (P=0.032); vitrectomy (P=0.035); and intraocular C3F8 gas tamponade (P=0.038). Excellent visual outcome (defined as ≥0.5 logMAR) was associated with age <50 years (P=0.003); better presenting visual acuity (PVA) (P < 0.001); wound length <4 mm (P=0.005); absence of vitreous hemorrhage (P=0.026) and retinal breaks (P < 0.001); nonvitrectomy surgery (P=0.043); and use of balanced saline (P=0.029). Conclusions Multiple prognostic factors were identified that may predict visual outcome and globe survival after IOFBs injury. Age, initial presenting visual acuity, wound length, complications (vitreous hemorrhage, retinal breaks, and endophthalmitis), surgical approach, and intraocular tamponade were significant predictors of visual outcome.
Highlights
Intraocular foreign bodies (IOFBs) are a leading cause of visual morbidity and blindness, especially in the working population [1, 2]. e management of IOFBs is a major challenge to the ophthalmologist, due to their specific clinical implications, as well as the diversity of associated changes, the severity of complications, and the specificity of diagnosis and treatment
Other variables including initial and final best-corrected visual acuities (BCVA); detailed information about IOFBs, such as the size, number, type, and location; and the time before IOFBs removal were obtained from the patients’ records. Complications such as cataract, vitreous hemorrhage, retinal breaks, retinal detachment, and endophthalmitis were noted along with the associated diagnostic studies and procedures. e study did not include relative afferent pupillary defect (RAPD) as a predictive factor because of the limited number of cases. erefore, it could not be determined as a probable prognostic factor for poor visual outcomes because of statistical bias
We further elucidated the risk factors affecting visual outcome and complications. e aim of our study was to evaluate the changes in BCVA, determine prognostic factors, assess ocular complications, and analyze the efficiency of surgical procedures for IOFBs injury
Summary
Intraocular foreign bodies (IOFBs) are a leading cause of visual morbidity and blindness, especially in the working population [1, 2]. e management of IOFBs is a major challenge to the ophthalmologist, due to their specific clinical implications, as well as the diversity of associated changes, the severity of complications, and the specificity of diagnosis and treatment. Intraocular foreign bodies (IOFBs) are a leading cause of visual morbidity and blindness, especially in the working population [1, 2]. E management of IOFBs is a major challenge to the ophthalmologist, due to their specific clinical implications, as well as the diversity of associated changes, the severity of complications, and the specificity of diagnosis and treatment. Prognosis for vision in IOFBs was dependent on confluent predictive factors, including age, length of wound, time between injury and repair, volume of IOFBs, and complications such as relative afferent pupillary defect (RAPD), retinal detachment and endophthalmitis, as published by previous authors [3, 4]. Most of the available data derived from other world populations outside China. We evaluated 373 eyes with IOFBs; here, we present our findings, based on the current literatures, to determine the potential prognostic factors and analyze the efficiency of the surgical procedures
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