Early versus late removal of retained intraocular foreign bodies

To compare early versus late removal of retained intraocular foreign bodies (IOFBs).

Sixty-two patients presenting with open-globe injuries due to lacerations by retained IOFBs were consecutively operated by the same surgeon between 1989 and 1997. Minimum follow-up was more than 3 months. In 43 patients, the IOFB was removed during the first 24 hours after the accident. In 19 patients, in whom the wound had been closed during a first operation, the IOFB was removed later than 24 hours after the accident. The study groups did not vary significantly in age, refractive error, type and size of IOFB, prevalence of traumatic cataract and peripheral or central corneal lacerations, or visual acuity on presentation.

Endophthalmitis developed significantly more often in the late intervention group than in the early intervention group (3/19 [15.7%] versus 1/43 [2.3%]; P = 0.0467; chi-square test). Considering patients with retinal lesions due to the IOFB (n = 47), proliferative vitreoretinopathy occurred significantly more often in the late intervention group than in the early intervention group (6/13 [46.2%] versus 6/34 [17.6%]; P = 0.0449).

Confirming previous reports, the results of the current study suggest that removing retained IOFBs within the first 24 hours after the injury may in some clinical situations reduce the risks of infectious endophthalmitis and proliferative vitreoretinopathy.