Abstract
Purpose. To analyze risk factors for endophthalmitis and retinal detachment (RD) in patients with retained intraocular foreign bodies (IOFBs). Design. A retrospective, interventional, consecutive case series. Participants. All patients treated at Bascom Palmer Eye Institute for traumatic IOFBs between 1999 and 2008. Methods. Analysis of visual outcome, mechanism of injury, management, and postoperative course. Results. 108 eyes with IOFBs were identified. Endophthalmitis occurred in 7 eyes (6.4%) at presentation, and risk was higher with vegetable matter exposure (P = 0.003). All eyes with posterior segment IOFBs received intravitreal antibiotics and there were no cases of endophthalmitis after initial management. RD was identified in 6 of 108 eyes (5.5%) at presentation. Risk factors were entry more than 5 mm behind the limbus (P < 0.001) and posterior segment IOFB (P = 0.028). Postoperative RD occurred in 11 of 102 eyes (10.7%). Risk factors for postoperative RD were preoperative endophthalmitis (P = 0.001), posterior segment IOFB (P = 0.008), and retinal impact sites (P = 0.028). Conclusions. Risk factors for endophthalmitis included vegetable matter exposure and delay to initial management. Risk factors for RD were posterior entry site, posterior segment IOFB, endophthalmitis, and retinal impact sites. No eyes developed endophthalmitis after presentation.
Highlights
Retained intraocular foreign bodies (IOFBs) are potential sources of severe visual loss
The current study investigates risk factors for endophthalmitis and retinal detachment (RD) in patients with retained IOFBs, employing a retrospective cohort of patients with a history of IOFB treated at a single ocular trauma center over a ten-year period
Anterior segment IOFBs were identified in 41 eyes (38.0%), of which 29 eyes (70.7%) were anterior to the lens, with a mean preoperative visual acuity (VA) of 20/80, and postoperative last corrected VA of 20/63 (P = 0.84)
Summary
Retained intraocular foreign bodies (IOFBs) are potential sources of severe visual loss. IOFBs have been estimated to occur in 10–41% of open-globe injuries [1,2,3,4]. Severe visual loss may be associated with the original injury, secondary endophthalmitis, rhegmatogenous retinal detachment (RD), or a variety of long-term complications including glaucoma, cataract, inflammation, or foreign body toxicity. Endophthalmitis has been reported in 2–30% of open-globe injuries with retained IOFBs [8,9,10], and an IOFB may be present in 43% of eyes with traumatic endophthalmitis [11]. RD has been reported in 6–30% of eyes with IOFBs [6, 12, 13]
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