Management of Posterior Segment Foreign Bodies and Long-Term Results

Karel, I; Diblik, Pavel

doi:10.1177/112067219500500208

Cited by 30 publications

(12 citation statements)

References 13 publications

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“…In agreement with previous reports (Heimann et al 1983;Karel & Diblik 1995), our results showed that RD was a crucial factor for poor visual outcome after IOFB injuries. Two multivariate analyses (Hutton & Fuller 1984;Brinton et al 1982) demonstrated that eyes with RD had a worse prognosis in severe ocular trauma.…”

Section: Discussionsupporting

confidence: 94%

Intraocular foreign bodies. Factors influencing final visual outcome

Chiquet

Zech

Denis

et al. 1999

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To identify the prognostic factors of poor visual outcome (visual acuityAE6/240) in eyes with intraocular foreign bodies. Methods: The records of 95 consecutive patients were retrospectively reviewed for 6 years (1990-1995). All eyes underwent a primary surgical repair and foreign-body removal (electromagnet or vitrectomy). The mean follow-up period was 25 months (6-72 months). Single analysis and multiple logistic stepwise regression analysis were performed to determine predictors of poor vision. Results: Thirty patients (31.6%) showed 6/240 or worse vision at the end of their follow-up period. Three significant predictive factors had independent and combined effects on post-operative visual outcome: a corneo-scleral entry wound (odds ratio (OR)Ω14.5, pΩ0.001), largest diameter of IOFB (ORΩ1.21, pΩ 0.01) and the presence of secondary retinal detachment (ORΩ9.48, pΩ0.0002). Post-operative complications included traumatic cataracts (51%), retinal detachments (28%) and phthisis bulbi (8%).Conclusion: Using multivariate analysis, corneo-scleral entry wound, largest diameter of foreign body and secondary retinal detachment were found to be predictors of poor visual outcome after intraocular foreign body removal. Our results suggest that patients with high-risk intraocular foreign body trauma should be candidates for pars plana vitrectomy rather than electromagnet procedure.

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Section: Discussionsupporting

confidence: 94%

Intraocular foreign bodies. Factors influencing final visual outcome

Chiquet

Zech

Denis

et al. 1999

Acta Ophthalmologica Scandinavica

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“…Other authors reported 8%–17% after magnetic extraction 311 29 30Two multivariate analyses 17 26 demonstrated that retinal detachment had a poorer prognosis in severe ocular trauma. Percival 24 noted 22% of eyes with postoperative retinal detachment and found four essential risk factors: intravitreous haemorrhage (odds ratio (OR) 8.4), foreign body size over 1 mm 3 (OR 4.5), transvitreous manipulation (OR 1.8), and vitreous loss (OR 1.7).…”

Section: Discussionmentioning

confidence: 99%

Visual outcome and prognostic factors after magnetic extraction of posterior segment foreign bodies in 40 cases

Chiquet

Zech

Gain

et al. 1998

British Journal of Ophthalmology

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Aims-To evaluate the clinical features as well as the visual and anatomical outcome in eyes with magnetic posterior segment foreign bodies, to identify prognostic factors after removal using an electromagnet. Methods-The records of 40 patients with posterior segment foreign bodies were retrospectively reviewed for 6 years (1989-94). Post-traumatic cataracts and secondary retinal detachments were treated using conventional surgical techniques. Pars plana vitrectomy was used only for late complications. The mean follow up was 30 months (6-71). Clinical factors were studied using univariate analysis. Results-The most common findings before treatment of these 40 eyes were lens wound, hyphaema, vitreous haemorrhage, and retinal impairment. The foreign body was in the vitreous (85%) or minimally embedded in the retina (15%). Initial visual acuity was worse or equal to 20/40 in 70% of the cases. Subsequent to surgical treatment, a cataract was reported in 60% of the patients. Postoperative complications included retinal detachment (15%) and phthysis (5%). The prognosis was worse in cases with intraocular foreign body of largest diameter >3 mm, an initial visual acuity less than 20/200, or the presence of post-traumatic retinal detachment. Presence of initial intravitreous haemorrhage, hyphaema, or intraocular tissue prolapse did not appear to aVect the prognosis. Conclusion-The long term visual acuity results indicated that wound repair associated with conventional magnet extraction in an emergency is a viable treatment for posterior segment magnetic foreign bodies in this selected group. At the time of diagnosis, size of foreign body (<3 mm) and initial visual acuity >20/200 were predictors of good visual outcome after primary magnetic extraction. (Br J Ophthalmol 1998;82:801-806)

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“…Závažnost tohoto typu poranění spočívá především v riziku rozvoje infekční komplikace, toxické reakce na cizí těleso a rozsahu oční léze v průběhu nitrooční trajektorie cizího tělesa [16]. Jako negativní prognostické faktory byly definovány: velikost nitroočního tělesa větší než 5 mm 2 , přítomnost relativního aferentního pupilárního defektu (RAPD), prolaps nitroočních tkání, přítomnost odchlípení sítnice nebo krvácení do sklivce při vstupním vyšetření a vstupní zraková ostrost horší než 0,1 [8,14,16].…”

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Rušňák

Hecová

2020

CSO

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Purpose: Penetrating eye trauma with an intraocular foreign body is very frequent, especially in men in their productive age. Pars plana vitrectomy would be the standard surgical method at our department. However, in indicated cases (metallic intraocular bodies in the posterior eye segment in young patients with well transparent ocular media without detached ZSM and without any evident vitreoretinal traction) transscleral extraction of the intraocular foreign body is performed using the exo magnet, eventually endo magnet with a minimal PPV without PVD induction under the visual control of endo-illumination. Materials and Methods: Between June 2003 and June 2018, 66 eyes of 66 patients diagnosed with a penetrating eye trauma caused by an intraocular foreign body located in the posterior eye segment were treated. In 18 eyes (27,3 %) with a metallic foreign body in vitreous (body) or in retina, no PPV or a minimal PPV without PVD was used as a surgical method. In the remaining 48 eyes (72,7 %), a standard 20G, respectively 23G PPV method were used together with PVD induction and the foreign body extraction via endo or exo magnet. Conclusions: As demonstrated by our survey/study, in the cases of a thoroughly considered indication an experimented vitreoretinal surgeon can perform a safe NCT transscleral extraction from the posterior eye segment via exo magnet, eventually endo magnet under the visual control of a contact display system with a minimal PPV. Thereby, the surgeon can enhance the patient´s chance to preserve their own lens and its accommodative abilities as well as reduce the risk of further surgical interventions of the afflicted eye.

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Management of Posterior Segment Foreign Bodies and Long-Term Results

Cited by 30 publications

References 13 publications

Intraocular foreign bodies. Factors influencing final visual outcome

Intraocular foreign bodies. Factors influencing final visual outcome

Visual outcome and prognostic factors after magnetic extraction of posterior segment foreign bodies in 40 cases

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