Xing Xiaoli, Liu Fang, Qi Yan, Li Jun, Yu Bin, Wan Lei
Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, QingDao, People's Republic of China.
State Key Laboratory Cultivation Base, Shandong Provincial Laboratory of Eye Diseases, QingDao, People's Republic of China.
Clin Ophthalmol. 2024 Dec 7;18:3635-3643. doi: 10.2147/OPTH.S492986. eCollection 2024.
This study aims to describe the epidemiology and clinical features of patients with intraocular foreign bodies (IOFBs) and analyze the prognostic factors influencing final vision.
We retrospectively reviewed medical records of patients with IOFBs admitted to Qingdao Eye Hospital of Shandong First Medical University between January 1, 2014, and December 31, 2021. Inclusion criteria involved complete clinical data details of patients diagnosed with intraocular foreign bodies in our hospital who were treated with concurrent surgery and based on IOFB position and characteristics, different surgical methods were employed. The minimum follow-up duration was 6 months. Exclusion criteria were foreign bodies retained in the orbit, organ failure, surgical contraindications, coagulation abnormalities, autoimmune diseases, history of ocular surgery, and ocular space-occupying lesions. Based on IOFB position and characteristics, different surgical methods were employed. Multivariate logistic regression analysis was performed to predict independent factors influencing final visual acuity after IOFBs.
This study analyzed 159 patients (159 eyes) with IOFBs. Based on discharge and follow-up results, IOFB removal was performed through pars plana incision in 105 (67.9%) eyes, corneoscleral limbus incision in 24 (15.1%) eyes, and original wound in 27 (17.0%) eyes. Of these, 44 eyes underwent IOFB removal without vitrectomy, while 55 (34.6%) eyes were treated with silicone oil. Post-vitrectomy, three cases showed secondary macular membrane, five cases exhibited retinal detachment, and enucleation was necessary in three cases. The final best corrected visual acuity (BCVA, logMAR) was 1.06 ±0.88, significantly better than preoperative visual acuity of 1.65 ±0.87 (t = 8.21, p < 0.01). Multi-factor logistic regression analysis revealed that the length of corneal/scleral wound (OR=0.6 P < 0.05), maximum size of IOFB (OR=0.585 P < 0.05), initial presenting VA (OR=0.900 P < 0.05), and macular lesions(OR=0.400 P < 0.05) were risk factors for postoperative vision prognosis after intraocular foreign body surgery.
In a tertiary eye center in northern China, IOFBs predominantly affected the working-age group, particularly males. Factors such as wound length, IOFB size, initial presenting VA, and macular lesions might impact the final visual outcome.
本研究旨在描述眼内异物（IOFB）患者的流行病学特征和临床特征，并分析影响最终视力的预后因素。
我们回顾性分析了2014年1月1日至2021年12月31日期间在山东第一医科大学附属青岛眼科医院收治的IOFB患者的病历。纳入标准包括在我院诊断为眼内异物并行手术治疗的患者的完整临床资料细节，并根据IOFB的位置和特征采用不同的手术方法。最短随访时间为6个月。排除标准为眼眶内异物残留、器官衰竭、手术禁忌证、凝血异常、自身免疫性疾病、眼部手术史和眼部占位性病变。根据IOFB的位置和特征，采用不同的手术方法。进行多因素logistic回归分析以预测影响IOFB后最终视力的独立因素。
本研究分析了159例（159眼）IOFB患者。根据出院和随访结果，105眼（67.9%）通过平坦部切口取出IOFB，24眼（15.1%）通过角巩膜缘切口取出，27眼（17.0%）通过原伤口取出。其中，44眼未行玻璃体切除术取出IOFB，55眼（34.6%）接受了硅油治疗。玻璃体切除术后，3例出现继发性黄斑膜，5例出现视网膜脱离，3例需要摘除眼球。最终最佳矫正视力（BCVA，logMAR）为1.06±0.88，明显优于术前视力1.65±0.87（t=8.21，p<0.01）。多因素logistic回归分析显示，角膜/巩膜伤口长度（OR=0.6，P<0.05）、IOFB最大尺寸（OR=0.585，P<0.05）、初始视力（OR=0.900，P<0.05）和黄斑病变（OR=0.400，P<0.05）是眼内异物手术后视力预后的危险因素。
在华北地区的一家三级眼科中心，IOFB主要影响劳动年龄组，尤其是男性。伤口长度、IOFB大小、初始视力和黄斑病变等因素可能会影响最终的视力结果。
