[Intraocular foreign bodies in the posterior eye segment].

BACKGROUND

A penetrating eye injury due to an intraocular foreign body (IOFB) may result in a poor vision and even in loss of the eye. A proper analysis of the cause of injury and of the injured eye enables a correct decision to be made concerning timing and method to be used not only for foreign body removal but also concerning of all sight saving surgical procedures.

PATIENTS AND METHODS

Over the years 1989-1993, 51 patients with an IOFB in the posterior segment of the eye were treated at the Department of Ophthalmology of the Comenius University in Bratislava. One patient was lost from the long-term observation and in two patients was an intraocular foreign body not removed. We evaluate results in 48 patients. The operative techniques used by foreign body removal and by reoperations are mentioned. The occurrence of peroperative and postoperative complications and the final anatomical and functional results are evaluated. An average follow-up period was 40.7 months. The value of the following prognostic factors was considered in relation to the final visual acuity: size and location of the laceration of the eye, size of IOFB and time of IOFB removal. The statistical significance was tested by Chí-square. Fischer's coefficient for tetrachoric tables was used for the calculation of power of dependence.

RESULTS

The foreign body was removed from 64.6% of the eyes after pars-plana vitrectomy. Foreign body caused serious damage of the intraocular structures in 37.5% of the eyes. The poor anatomical result was achieved in 18 (37.5%) and good in 30 eyes (62.5%). In twelve eyes (25%) was implanted an IOL. The final visual acuity of 6/9-6/6 was achieved in 18 (37.5%) and visual acuity lower than 2/60 was recorded in 21 (43.7%) of the eyes. The prediction of bad visual acuity (lower than 2/60) was significant related to: all lacerations except of corneal wounds smaller than 4 mm, IOFB size exceeding 3 x 2 mm.

CONCLUSIONS

Management of retained intraocular foreign bodies should be individual and is dependent on the extent of the initial injury and the characteristics and location of the IOFB. The final outcome depends mostly on the extent of the primary injury and of the occurrence of the peroperative and postoperative complications.