Metallic Intraocular Foreign Body Research Articles

An unexpected retained metallic intraocular foreign body.

This case report aims to describe a rare case of asymptomatic retained metallic intraocular foreign body (IOFB) in the retina with reduced full-field electroretinography (ff-ERG) in a Chinese woman. This is a clinical investigation of a patient who unexpectedly presented with a metallic IOFB at the superior-temporal region of the left eye ring during a brain computed tomography. Her best-corrected visual acuity was 20/20 in both eyes. The dilated fundus photograph of the left eye revealed a metallic IOFB in the retina. She reported no ocular symptoms. A diagnosis of asymptomatic metallic IOFB was made definitely. The subsequent ff-ERG demonstrated subnormal amplitudes of dark and light adaption in the left eye, whereas responses were normal in the right eye. Our findings suggest the application of ff-ERG has important benefits for evaluating the visual function in patients with retained IOFB.

Use of Cohesive Viscoelastic Agents to Facilitate Safe Removal of Posterior Segment Intraocular Foreign Bodies.

Purpose: To assess the ability of viscoelastic agents and perfluoro-N-octane (PFO) to safely remove an intraocular foreign body (IOFB). Methods: A 23-gauge pars plana vitrectomy and lensectomy were performed in a porcine eye. A 5.0 mm metallic IOFB was inserted through a corneal paracentesis and dropped into the vitreous cavity. The posterior segment was filled completely with a balanced salt solution, cohesive viscoelastic, or dispersive viscoelastic or partially filled with PFO under a balanced salt solution. The IOFB was then brought anteriorly and released. Each test was repeated multiple times and videorecorded. Results: The IOFB fell with high velocity through the balanced salt solution-filled vitreous cavity. When the eye was filled with either of the 2 viscoelastic agents, the IOFB did not move or moved posteriorly extremely slowly. A vitreous cavity filled partially with PFO led to deflection of the object's path, with the peripheral retina being struck, or the IOFB dropping straight down and striking the macula. PFO and the cohesive viscoelastic were easily removed from the eye with the vitrectomy instrument. The dispersive viscoelastic could not be completely removed and repeatedly clogged the vitreous cutter. Conclusions: Filling the posterior segment with a cohesive viscoelastic agent may significantly increase the safety and ease of IOFB removal.

Demystifying the role of magnetic resonance in identifying intraocular foreign bodies: a case of ocular siderosis

BackgroundOcular siderosis (OS) is a significant cause of visual loss due to retained ferrous intraocular foreign bodies (IOFB). Despite its rarity, OS can lead to severe visual impairment if not promptly diagnosed and treated. This case is notable due to the occult nature of the IOFB, which was undetected by standard imaging modalities, emphasizing the critical role of magnetic resonance imaging (MRI) in such scenarios.Case presentationA 51-year-old Caucasian male presented with progressive vision loss in his right eye over 20 days. Best corrected visual acuity (BCVA) was 20/1000 in the right eye and 20/20 in the left eye. Intraocular pressure (IOP) was 9 mmHg in both eyes. Slit-lamp examination revealed a small linear corneal wound and an iris defect in the right eye, along with a cataract featuring brownish deposits on the anterior capsule. The left eye was normal. Fundus examination of the right eye was hindered by media opacities. Ultrasonography showed a flat retina and choroid with no detectable IOFB. Despite a strong clinical suspicion of OS, computed tomography (CT) did not detect any IOFB. MRI subsequently identified an artifact in the inferior sectors of the right eye, indicative of a metallic IOFB. Surgical intervention involved a 23-gauge vitrectomy, phacoemulsification, IOFB removal and silicon oil (SO) tamponade resulting in a fully restored VA of 20/20 and normal IOP one month post-operation. SO was removed 2 months later. The retina remained adherent with no PVR development, and optical coherence tomography (OCT) scans showed a normal macula.ConclusionsThis case underscores the importance of considering OS in patients with unexplained vision loss and history of ocular trauma, even when initial imaging fails to detect an IOFB. MRI proved crucial in identifying the IOFB, highlighting its value in the diagnostic process. Early detection and surgical removal of IOFBs are essential to prevent irreversible visual damage. This case demonstrates that MRI should be employed when CT and ultrasonography are inconclusive, ensuring accurate diagnosis and timely intervention to preserve vision.

Surgical techniques for optimal lens management of posterior segment metallic intraocular foreign body removal: a case series.

We describe three different approaches for lens management in cases of metallic IOFBs involving the posterior segment. All consecutive posterior segment metallic IOFB cases from 2012 to 2023 at a single institution were included in this retrospective case series. Surgical outcomes and surgical videos are presented. A total of 25 metallic IOFB cases were included. In 9 cases, there was no significant lens involvement, therefore not requiring lens extraction at the time of IOFB removal. In 8 cases with traumatic cataract, lens extraction sparing the anterior lens capsule was performed with IOFB removal. In 8 cases, both lens extraction and lens capsule removal were required at the time of IOFB removal. We demonstrate our algorithm to capsular management in patients who present with IOFB with good visual outcomes in follow-up.

Letter to the editor on 'Combined Phacovitrectomy with Metallic Intraocular Foreign Body Removal through Corneal Incision Using A Novel "Magnetic Conduction" Technique'.

Letter to the editor on 'Combined Phacovitrectomy with Metallic Intraocular Foreign Body Removal through Corneal Incision Using A Novel "Magnetic Conduction" Technique'.

Comparing forceps and self-assembled intraocular rare earth magnet in removing metallic intraocular foreign bodies in 25-guage vitrectomy

PurposeTo compare the efficacy and efficiency of self-assembled intraocular rare earth magnet and forceps in removing intraocular foreign bodies(IOFBs) undergoing 25-gauge(G) pars plana vitrectomy.MethodsA total of 30 patients with metallic IOFB underwent 25-G PPV were enrolled into this study. Self-assembled intraocular rare earth magnet were used in 15 patients(bar group), and forceps were used in 15 patients(forceps group). Success rate of removing IOFB, time taken to remove IOFB, incidence of IOFB slippage and fall, iatrogenic retinal damages were compared between the two groups.ResultsThere was no significant difference in success rate of removing IOFBs between the groups(93.3% and 100%, P > 0.99). The median time taken of removing FB was significantly shorter in bar group than in forceps group(112 and 295 s, P = 0.001). None of the patients in bar group had IOFB slippage and fall, or related iatrogenic retinal damage in the process of removal. In forceps group, IOFB slippage and fall during removal were observed in 7 of 15(47.6%) patients, related iatrogenic retinal injuries were recorded in 6 of 15(40.0%) patients, both were significantly higher than bar group(P = 0.003 and P = 0.017, respectively).ConclusionsCompared with forceps, the assembled intraocular magnet can greatly reduce the possibility of IOFB slippage and fall, prevent related iatrogenic retinal damage, and shorten the time taken to remove IOFB. The assembled intraocular magnet can be an useful tool in removing metallic IOFBs in PPV.

Imaging Mismatch of Nail in the Eyeball: What’s next?

Introduction : A retained foreign body (FB) can lead to severe complications, the most devastating of which is eye loss. We present a discrepancy of imaging that resulted in a dilemma in the approach management of a mixed global-adnexal FB case.
 Case Illustration : A 31-year-old man came to the emergency room with blurry vision for 1.5 hours after a nail hit his right eye (RE). The visual acuity of RE is light perception. Ophthalmological examination revealed a central Y-shaped full-thickness corneal laceration with iris and vitreous prolapse. The lens appeared cloudy, and the posterior segment was difficult to assess. Imaging showed a foreign metal object asa nail in the oculi to intraconal without penetration to the orbital wall. He was planned to undergo FB extraction with corneal laceration repair and aspiration of lens mass irrigation. However, the nail was hard to find intraoperatively because the vitreous and choroid kept coming out. Hence evisceration with DFG was performed. The nail was found more posteriorly and attached to the bone.
 Discussion : While primary repair is the standard practice for open globe injury, managing retained intraocular metallic foreign bodies is controversial. Imaging such as CT scans can help determine the location of FB and approach management. In this case, imaging showed the FB was in the iris plane and not penetrating the orbital wall, so primary repair and FB extraction were planned.
 Conclusion : The imaging may not always be accurate in determining the exact location of FB, and the surgical approach may need to be adjusted accordingly.

Subconjunctival deferoxamine for corneal rust deposits associated with ocular siderosis: A case report

Introduction: Ocular siderosis is a vision-threatening condition resulting from intraocular iron toxicity. This case re-establishes a role for subconjunctival deferoxamine, a chelating agent uncommonly used in ophthalmology, as an adjunctive treatment for ocular siderosis. Case Report: A 37-year-old healthy male presented two months after an injury at work with intermittent pain and blurry vision in the right eye. Presenting visual acuity (VA) was 20/100 in the right eye. With delayed presentation, the patient already had ocular siderosis with corneal rust deposits and retinal damage. The patient underwent pars plana vitrectomy (PPV) with surgical view impaired by corneal deposits and intraocular metallic intraocular foreign body (IOFB) that disintegrated upon attempted removal. At six months postoperatively, VA was 20/70 in the right eye, and examination revealed worsened diffuse, pigmented subepithelial deposits in the central cornea, iris atrophy, cotton wool spots, optic nerve pallor, and a residual IOFB in the anterior vitreous, consistent with worsened ocular siderosis. Superficial keratectomy was performed in combination with repeat PPV to improve surgical visualization and aid in IOFB removal. An amniotic membrane was placed and a subconjunctival injection of deferoxamine was administered. The cornea was well-healed with significantly improved siderosis and no epithelial defects on 2-week postoperative follow-up. Visual acuity was 20/60 at last follow-up two months postoperatively after second surgery. Conclusion: In treating ocular siderosis, subconjunctival injection of deferoxamine can be a useful addition to surgical IOFB removal to prevent the accumulation of iron deposits in the anterior segment of the eye.

Improved intraocular foreign body localization using orbital computed tomography data

Background: Detection and localization of an intraocular foreign body (IOFB) are essential for assessing the severity of injury and selecting an appropriate method for IOFB removal. Purpose: To improve the method of IOFB localization through the use of the Komberg-Baltin prosthesis while performing orbital computed tomography (CT) scans. Material and Methods: We reviewed the medical records of 6 patients with a penetrating corneal and/or scleral injury and an IOFB in the posterior segment. Patients had ultrasonography of the ocular anterior and posterior segments and Komberg-Baltin prosthesis-assisted CT of the orbit as per our method reported previously to verify the location of the IOFB. Orbital radiography was performed at the point of care. The results of radiography, ultrasonography and CT for each case were reviewed and compared. The final verification of IOFB location was performed preoperatively during a standard three-port 25-G pars plana vitrectomy with IOFB removal. Results: In 3 cases, intraoperative visualization during vitrectomy confirmed the results of preoperative IOFB imaging (radiography, ultrasonography and orbital CT). In these cases, an IOFB was a metallic fragment measuring 0.9 to 2.5 mm. In one case, a metallic IOFB was found by ultrasonography, but not by radiography. CT, when performed by our method, found an IOFB measuring 0.2 x 0.3 mm preretinally. In a patient with an IOFB (a wire measuring 10.0 x 1.0 mm, at 20 mm from the anatomical axis, and 9-11.5 mm from the limbal plane) and local retinal detachment, there was a discrepance between the foreign body location indentified by radiography and that identified by CT with the use of the Komberg-Baltin prosthesis. Large differences in the distance between the IOFB and the limbal plane and between the IOFB and the anatomical axis (4 mm and 5 mm, respectively) were caused by the mobility of the foreign body located beneath the retina. Conclusion: Localizing an IOFB using Komberg-Baltin prosthesis-assisted CT is advantageous to radiography due to an opportunity for accurate localization of a mobile IOFB with a patient in the position as similar as possible to his position during IOFB removal surgery (i.e., the supine position).

Combined Phacovitrectomy with Metallic Intraocular Foreign Body Removal through Corneal Incision Using A Novel "Magnetic Conduction" Technique.

To describe a "magnetic conduction" technique for the removal of metallic intraocular foreign bodies (IOFBs) in the posterior segment combined with cataract extraction and pars plana vitrectomy and to report its outcomes. We retrospectively analyzed the data of 42 eyes of 42 patients with posterior metallic IOFBs between April 2020 and February 2022. In all patients, cataract extraction was combined with pars plana vitrectomy. With an external magnet, the IOFBs were captured by a magnetized vitrectomy cutter, delivered to the anterior chamber, and then extracted through a corneal phacoemulsification incision. All patients were men, with a mean age of 45.6 ± 10.7 years. The mean size of the IOFBs was 3.5 ± 1.7 mm (range, 1.5-8.9 mm) in their longest dimension. A final best-corrected visual acuity of 20/200 or better was noted in 24 of 42 patients (57.1%). Postoperatively, recurrent retinal detachment was seen in three eyes. There were no other intraoperative or postoperative complications. The "magnetic conduction" technique combined with phacovitrectomy is a safe and feasible approach to removing IOFBs in the posterior segment.

REVIEW 5 TAHUN KARAKTERISTIK KLINIS PASIEN BENDA ASING INTRAOKULAR DI PMN RS MATA CICENDO

Introduction: Intraocular foreign bodies (IOFBs) are defined as intraocularly retained, unintentional projectiles that require urgent diagnosis and treatment to prevent blindness or globe loss. IOFBs account for 18–41% of open globe injuries, and frequently cause severe visual loss in patients with ocular trauma.The purpose of this study are is to describe the characteristics of open-globe injuries with posterior segment intraocular foreign bodies (IOFB). Subject and Methods: Retrospective data of all patients with posterior segment IOFBs from 2017 to 2022 was conducted. Data including demographics, mechanism of injury, type of IOFB, method of diagnosis, presenting examination, medical and surgical treatment, visual outcomes, and complications were recorded. Result: There were 39 patients (eyes) with IOFB, 38 (97,4%) were male, 10 (25,6%) were 46-55 years old. The most common IOFB occurred at workplace 30 patient (85,7%), 29 (74,3%) were insuranced, surgery were performed 1- 4 days in 15 (38,5%. The most Ocular trauma score were 3 (38,5%) and 2 (35,9%) initial VA were light perception – hand movement (25 or 64,1%), final VA with BCVA were > 20/40 (30,8%) patients and 6/60-6/15 (25,6%). The posterior segment IOFB (51,3%, metallic IOFB 25 (61,5%). Cataract 74,3% and Endophthalmitis (20,5%) were found in initial examination patient with IOFB (13 or 37,1%). Late complication in post surgery IOFB patient was glaucoma 14,4%. Conclusions: The IOFB occurred most commonly in adults, men, at the workplace. The IOFB mostly was metallic, found in the posterior segment. Cataract and endoftalmitis were common in initial finding IOFB patients.

Traumatic intraocular foreign bodies

Background Ophthalmic trauma caused by intraocular foreign bodies (IOFBs) can impact visual prognosis by generating direct ocular structural damage. Factors bearing poor visual prognosis are related to size and velocity of IOFB, location in posterior segment with associated retinal detachment or endophthalmitis. Current study is aimed to evaluate size and location of IOFB and associated ocular structural damage. Methods In this retrospective study done at single tertiary center, patients injured by IOFBs were analyzed between January, 2010 to January, 2021 for ocular structural damage caused by size, velocity and location of impacted IOFB. All were assessed for corneal or scleral perforation and other structural damage due to IOFB. Location, route of retrieval and size of IOFB was measured. Results All 41 eyes were operated for removal of metallic IOFB. Corneal repair was done in 90.2% and scleral repair in 9.8% eyes. Hyphema cleared in 53.6% eyes. Traumatic cataract in 85.4% requiring phacoemulsification, preexisting aphakia (previous surgery) and siderosis was seen in 2.4% eyes. Retinal detachment was present in 14.6% and endophthalmitis in 4.9% eyes. Location of IOFB was on iris and lens in 2.4% each, with 19.5% impacted in retina and 75.6% were isolated in vitreous cavity. Small size IOFB was 58.3%, medium size was 29.3%, large size was 4.9% and very large size was 7.3%. No eye was deformed requiring evisceration of enucleation. Corneal or scleral repair, phacoemulsification, pars plana vitrectomy and intraocular foreign body removal as one stage procedure was done in each case. Intraocular lens implantation was done where sufficient anterior or posterior capsule was present. Conclusion Trauma caused by IOFB is commonly seen at workplace in young male laborers. It usually presents as corneal or scleral perforation, traumatic cataract, endophthalmitis and retinal detachment. Level of structural damage to ocular structures is dependent on the size, velocity and location of IOFB impaction. One stage surgical intervention for wound closure and IOFB should be considered for better surgical prognosis.

Metallic intraocular foreign body removal assisted through the extrusion line

AbstractPurpose: To describe an alternative vitreoretinal surgical manoeuvre, to remove metallic intraocular foreign bodies.Methods: Two patients, at different time lines, underwent vitrectomy to remove a metallic intraocular foreign body (IOFB). A 3‐port vitrectomy was performed, a 23‐G constellation vitrectomy equipment was used in both procedures, careful core vitrectomy was first done, vitreous adhesions and vitreous detachment was carefully done, retina was partially detached at the IOFB location, vitreous adhesions were cut and released gently not to increase the retinal detachment. Liquid prefluorocarbon was placed on the macula. As the vitreous adherences were cut, the IOFB was free from all potential tractional forces, the soft silicone tip cannula was held on to its surface, and at maximal vacuum aspiration, the IOFB was brought up to the anterior chamber, switching the light pipe for forceps in the other hand, and removed out of the eye. A complete as possible vitrectomy was performed, intraocular laser around the retinal brakes was performed, an intraocular lens was placed in the ciliary sulcus with the optic within the anterior capsule, and silicone oil was used as tamponade.Results: No signs of intraocular inflammation were recorded postoperatively. Intraocular silicone oil removal was done at the third post‐operative month in both cases, retina remained attached through follow up, both patients had over 9 months follow‐up visits, visual acuity improved from initial presentation, and also improved after the silicone oil tamponade removal.Conclusions: Active aspiration through the soft silicon tip cannula can be used to reach, and assist removal of metallic intraocular foreign bodies, being this manoeuvre safe, reproducible, possibly time‐saving, and also it could potentially avoid the risk of IOFB mobilization, avoiding further damage to the retina.

Клинический случай лечения пациента с симпатической офтальмией

The clinical case of observation and treatment of patient M., 45 years old, who received in 2011 an open injury of the right eye with a metallic intraocular foreign body, complicated by damage to the lens and hemophthalmos. Primary surgical treatment with diascleral removal of the foreign body was performed on the same day. Subsequently, repeated surgical interventions, including vitreoretinal ones, were performed on the injured eye. 11 years after the injury, the patient was diagnosed with chronic sympathetic uveoneuroretinitis in the left eye. The right eye was enucleated, immunosuppressive therapy was prescribed (systemic therapy with glucocorticosteroids in the form of pulse – therapy with transfer to tablet forms, cyclosporine A). Taking into account the posterior form of sympathetic ophthalmia, verification of the diagnosis at an advanced stage, late start of immunosuppressive therapy, its delayed effect, a strictly individual scheme of long-term controlled treatment of the patient with monitoring of his ophthalmological and somatic status is necessary. Keywords: sympathetic ophthalmia, open globe injury, enucleation, immunosuppressive therapy

LAWN TRIMMER-RELATED OPEN-GLOBE INJURIES IN TAIWAN.

Work-related ocular trauma remains the leading cause of unilateral visual impairment worldwide. Many preventable work-related ocular injuries continue to occur, even at home. This study describes the characteristics, surgical techniques, and prognostic factors of lawn trimmer-related open-globe injuries in eastern Taiwan. This was a retrospective, consecutive case series study. Slit-lamp biomicroscopy, dilated fundoscopy, and orbital computed tomography (CT) images were collected. Twenty-six eyes of 26 patients were enrolled in the study. Fifteen patients (57.7%) had an intraocular foreign body (IOFB). The IOFB was metallic in 13 cases and glass and stone in the other 2 cases. Seven IOFBs (46.7%) were retained in the anterior chamber, 7 (46.7%) in the posterior segment, and 1 (6.7%) in the intraconal space. Univariate analysis showed that the presence of IOFB trended toward the development of endophthalmitis; however, this was not statistically significant (hazard ratio, 2.25; 95% confidence interval 0.35-14.61; P = 0.658). Eleven patients had metallic IOFBs noted on CT scans with metal artifacts, whereas two patients had small metallic IOFBs without metal artifacts. One patient had a glass IOFB mimicking metal artifacts on the CT scan. In one case, CT failed to reveal the IOFB, and an intralenticular metallic foreign body was incidentally found intraoperatively. Our study provides a broad characterization of lawn trimmer-related open-globe injuries. The informative and diverse findings of IOFBs on CT scans will help clinicians detect and recognize IOFBs more precisely and perform the surgery without causing further damage.

Management and follow‐up of secondary unlikely location of Dexamethasone Implant: between sulcus 3‐pieces IOL and intact posterior capsule

AbstractPurposeManagement and follow‐up of secondary unlikely location of Dexamethasone Implant: between sulcus 3‐pieces IOL and intact posterior capsule.MethodsA 66‐year‐old man had a traumatism while cutting wood: he consulted 3 days later for severe endophthalmitis. A CT scan excluded any metallic intraocular foreign body (FB). Initial emergency surgery consisted in phacovitrectomy without implantation, bacteriologic and fungal samples, removal of small wood FB, antibiotic & antifungal intravitreal injections. No zonulolysis was present, no capsular tear occurred. Local and systemic treatment allowed good anatomic recovery. At 1.5‐month he developed Irvine‐Gass syndrome (CME).At 2‐months, conditions allowed secondary implantation with a 3‐pieces IOL in the sulcus due to anterior and posterior capsules fusion. As zonule and lens bag were well preserved, we injected intravitreal DI without adverse event (free in the posterior segment). Forty days after DI injection, he consulted in emergency for a hay straw in his left eye. Actually, the DI migrated to the anterior segment, just between sulcus IOL and intact posterior capsule. He had no pain, no redness, normal IOP, 0.2 logMAR far & near vision, and an impression of a paracentral scotoma. He reported repeated heavy loads lifting with head down in his farm, despite postoperative instructions. Medical treatment based on myotics (isotpopilocarpine), continuation of anti‐inflammatory drops, and prophylactic hypotonizing monotherapy drops associated with monthly complete monitoring (slit lamp/OCT/specular microscopy) was decided in first line‐therapy.ResultsSpontaneous disintegration of this ectopic DI took 2 months: CME disappeared completely in 1.5 month; IOL remained stable; no IOP elevation or endothelial damage occurred; vision went to 0.0 logMAR and paracentral scotoma disappeared.ConclusionsThis ectopic migration leading to DI sandwich enables good healing from a CME. Various options could have been chosen: among YAG capsulotomy, emergency surgery and medical treatment. Here, rigorous monitoring with precise iconographic sequences allows to estimate efficacy, safety and time of resorption in this unlikely location. DI injection should be really discussed for every trauma background.

"IRIS SHELF" TECHNIQUE FOR MANAGEMENT OF POSTERIOR SEGMENT INTRAOCULAR FOREIGN BODIES.

To describe "iris shelf" technique for removal of posterior segment intraocular foreign bodies (IOFBs) through a corneal incision combined with phacovitrectomy and to report its outcomes. Medical records of patients with posterior segment metallic IOFBs who had combined phacovitrectomy were collected and analyzed. In all patients, the IOFB was placed on the iris surface after forming the anterior chamber with viscoelastic to be extracted through a corneal phacoemulsification incision. Thirty-three eyes of 33 male patients with a mean age of 31.6 ± 8.3 years were included in the study. The mechanism of injury was hammering in 24 eyes (72.7%) and gunshot in 9 eyes (27.3%). The mean interval between injury and IOFB removal was 14.76 ± 6 days. The mean IOFB volume was 8.5 ± 5.5 mm3, and its longest dimension was 3.45 mm (range, 1-8 mm). The mean preoperative corrected distance visual acuity changed from 20/1,500 (1.79 logarithm of the minimum angle of resolution) to 20/94 (0.67 logarithm of the minimum angle of resolution), postoperatively (P < 0.001). Postoperative complications included retinal detachment (two eyes), proliferative vitreoretinopathy (one eye), epiretinal membrane (one eye), and posterior synechiae (three eyes). The "iris shelf" technique with phacovitrectomy is a safe and reproducible approach for posterior segment IOFB extraction through a corneal incision with favorable visual and anatomical outcomes.

Correlation Between Electroretinogram and Visual Prognosis in Metallic Intraocular Foreign Body Injury.

Purpose: This study aims to investigate the correlation between electroretinogram (ERG) and visual outcome in eyes with metallic intraocular foreign body (IOFB) injury.Methods: Cases with metallic IOFB injuries with preoperative ERG from January 2008 to May 2020 were reviewed retrospectively. Five ERG responses were recorded, including rod response, maximal response, oscillatory potentials, cone response, and 30-Hz flicker. The results were compared between the affected and the contralateral eyes. All patients received surgery to remove IOFBs. The correlation between amplitudes, implicit times, and grades of ERG with final best-corrected visual acuity (BCVA) was analyzed.Results: A total of 33 eyes of 33 patients were included. The eyes with IOFB had generally delayed implicit time and reduced amplitude in all waves. The maximum change was found in oscillatory potentials S3 and N1 (0.42 ± 0.42 and 1.95 ± 1.97 of the fellow eyes, respectively, p < 0.05). All amplitudes were negatively correlated with the final BCVA (rs: −0.676 to −0.459, all p < 0.05). In contrast, all implicit times were positively correlated with final BCVA, although, some of them were not statistically significant (rs: 0.035 to 0.687). Among them, oscillatory potential P3 has the highest correlation coefficient (rs = 0.687, p < 0.001). All grades of ERG waves were statistically correlated with the final BCVA (rs: −0.596 to −0.664, all p < 0.001).Conclusions: ERG can be used to assess visual outcome in metallic IOFB injury after surgery. Oscillatory potentials provided the most significant responses.

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

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.

Осложнения длительно пребывающего в глазу металлического внутриглазного инородного тела

Осложнения длительно пребывающего в глазу металлического внутриглазного инородного тела