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Intraocular foreign bodies: management, prognostic factors, and visual outcomes
C M Greven1, N E Engelbrecht, M M Slusher
1Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1033, USA. cgreven@wfubmc.edu
Objective:
To determine prognostic factors and visual outcomes in patients with intraocular foreign bodies (IOFBs).
Design:
Retrospective, noncomparative, interventional case series.
Participants:
Fifty-nine consecutive patients undergoing removal of an IOFB with a minimum of 6 months of follow-up.
Intervention:
Surgical removal of the IOFB and repair of associated ocular trauma.
Main Outcome Measures:
Final best corrected visual acuity was the main outcome measured. Ocular findings at presentation were compared with final visual acuity to determine prognostic factors for visual outcome.
Results:
Final best corrected visual acuity of 20/40 or more was obtained in 42 patients (71%) and ambulatory vision (>5/200) was achieved in 50 patients (85%). Presenting visual acuity was predictive of final visual outcome (P < 0.01). Prognostic factors for a better visual outcome (P < 0.05) included better presenting visual acuity and hammering metal on metal as the mechanism of injury. Prognostic factors for a poor outcome (P < 0.05) included poor presenting visual acuity, the presence of an afferent pupillary defect, and vitreous hemorrhage.
Conclusions:
Final visual outcomes were excellent in 71% of patients. Presenting visual acuity was the strongest predictor of final visual outcome in this series. Additional predictive factors included the mechanism of injury, the presence of an afferent pupillary defect, and vitreous hemorrhage.