Prognostic factors in vitrectomy for posterior segment intraocular foreign bodies

The aim of this study was to identify the prognostic factors influencing outcome after the removal of retained posterior segment intraocular foreign bodies (IOFBs) by pars plana vitrectomy.

We reviewed the records of 42 consecutive patients (39 men and 3 women with a mean age of 26.8 years) operated between January 2001 and January 2005 by the same surgeon for IOFB after penetrating ocular injury. All eyes underwent IOFB removal via pars plana vitrectomy. Postoperative retinal detachment was considered as the anatomic failure. Associations between anatomic outcome and various preoperative, operative, and postoperative variables were statistically analyzed. Chi-square test and Mann-Whitney U test were used to evaluate the association between two categorical variables.

The mean time interval between the trauma and the IOFB removal was 5.3 days (range, 1 day to 30 days). The mean length of follow-up was 18.3 months (range, 6 months to 3 years). Preoperative retinal detachment was present in 19% of patients. After the IOFB removal, the retina was detached in 28.5% of patients (12 of 42 patients). After a second vitrectomy performed in 10 patients, final anatomic success rate was 89.8% (37 of 42 patients). Time between trauma and IOFB extraction, presence of intraocular hemorrhage, preoperative retinal detachment and primary surgical repair combined with the IOFB removal were significantly associated with the postoperative retinal detachment. Age, sex, entrance wound location, presence of endophthalmitis, location of IOFB, nature of IOFB, preoperative visual acuity, use of an encircling band, type of endotamponade, use of lensectomy were not significantly associated with the presence of postoperative retinal detachment.

Delay in IOFB extraction, presence of intraocular hemorrhage, preoperative retinal detachment, primary surgical repair combined with IOFB removal are the predictive factors for anatomic failure.