Surgery for posterior segment intraocular foreign bodies -- anatomical and functional results

Brănişteanu, D.; Moraru, A.

Oftalmologia 57(4): 51-60

2013


ISSN/ISBN: 1220-0875
PMID: 24844038
Document Number: 15103
To assess the anatomical and visual outcome and also the retinal complications following vitreoretinal surgery for posterior segment intraocular foreign bodies (IOFBs). Retrospective analysis of 59 IOFBs, with different locations within posterior segment,removed during pars plana vitrectomy (PPV) between January 1999 and January 2011, by the same surgeon, in Eye Clinic 1 Iasi. 47 out of 59 IOFBs (79.66%) were removed immediately after primary wound closure and 12 with a delay ranging from 48 hours to 5 years. All IOFBs were metallic. Total 20G pars plana vitrectomy with IOFB removal by forceps or intraocular magnet, careful membrane peeling and laser photocoagulation around the retinal injury (if present) was performed. Relaxing retinotomy was necessary in 3 cases of retinal incarceration. Endotamponade with SF6 (26 cases) or silicone oil (8 cases) were performed, if needed, at the end of surgery. The average follow-up period after surgery was 17.9 month (ranging 6 - 36 months). 18 out of 59 IOFBs (30.5%) were intraretinal. 39 out of 59 eyes (66.10%) showed signs of endophthalmitis at the time of surgery. Preoperative visual acuity ranged from light perception to 0.6. The mean visual acuity significantly increased after surgery from 0.16 preoperatively to 0.5 at the end of follow-up (range hand movements--1). 51 out of 59 cases (86.44%) had stable anatomical result. A final visual acuity equal or better than 0.1 was obtained in 45 cases (76.27%). Mild retinal folding could be noticed in some cases around the laser-treated retinal injury. In 8 out of 59 cases (13.56%) visual acuity remained low or decreased due to macular injury or PVR associated retinal detachment requiring additional surgery. IOFBs, and especially those intraretinal, require an early, complex and customized approach during PPV. Functional results do not match anatomical restoration if macula or optic nerve are impacted. Main postoperative complications were represented by retinal folds and PVR associated retinal detachment.

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Surgery for posterior segment intraocular foreign bodies -- anatomical and functional results