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Endotamponades in pars plana vitrectomy for metallic intraocular foreign body associated with endophthalmitis
Rui Wang1, Xing-Li Wang, Yi Wang
1Department of Ophthalmology, the Affiliated Southwest Hospital of Third Military Medical University, Chongqing 400038, China.
Aim:
To study the criterion-reference of endotamponades in pars plana vitrectomy for metallic intraocular foreign body (MIOFD) associated with endophthalmitis.
Methods:
Thirty-six patients of MIOFD with endophthalmitis accorded with exclusion and inclusion criteria were retrospectively analyzed. A detailed analysis of the patients' natural factors, preoperative examinations, intraoperative endotamponades choice, postoperative complications and therapeutic effects was performed.
Results:
BSS was used in 4 eyes without obvious retinal damage. There was no postoperative complication and the visual acuity (VA) was improved. Sixteen eyes that had mild retinal damage filled with C3F8 gas. The postoperative VA improved in 10 eyes (62.5%), 4 eyes (25.0%) remained unchanged and 2 eyes (12.5%) decreased. Only 2 cases occurred postoperative retinal detachment in gas group. Another 16 eyes with serious retinal damage were treated with silicone oil. Postoperative VA of 9 eyes (56.3%) improved, 3 eyes (18.8%) remained unchanged and 4 eyes (25.0%) decreased. The silicone oil group had higher incidence of postoperative complications, but the incidence of secondary treatment had no significant different between silicone oil and gas group.
Conclusion:
An appropriate choice of endotamponades in vitrectomy surgery for MIOFB with endophthalmitis is important for prognosis.
Insights
Choosing the right endotamponade during vitrectomy for metallic intraocular foreign bodies with endophthalmitis is crucial. This study analyzed factors influencing outcomes, highlighting the importance of appropriate tamponade selection for better visual acuity and prognosis.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Retinal Surgery
Background:
- Metallic intraocular foreign bodies (MIOFD) with endophthalmitis present complex surgical challenges.
- Pars plana vitrectomy is a common surgical approach for MIOFD.
- Endophthalmitis following MIOFD significantly impacts visual prognosis.
Purpose of the Study:
- To evaluate the efficacy of different endotamponades in pars plana vitrectomy for MIOFD with endophthalmitis.
- To determine the criterion-reference for selecting endotamponades based on retinal damage.
- To analyze factors affecting visual acuity and postoperative complications.
Main Methods:
- Retrospective analysis of 36 patients with MIOFD and endophthalmitis.
- Evaluation of patient factors, preoperative status, intraoperative tamponade choice, and postoperative outcomes.
- Categorization of endotamponades used: BSS, C3F8 gas, and silicone oil.
Main Results:
- BSS group (no significant retinal damage) showed improved visual acuity without complications.
- C3F8 gas group (mild retinal damage) had a 62.5% improvement in visual acuity, with 2 cases of retinal detachment.
- Silicone oil group (severe retinal damage) had a 56.3% improvement in visual acuity but a higher incidence of complications.
Conclusions:
- The choice of endotamponade is critical for the prognosis of MIOFD with endophthalmitis.
- Tailoring tamponade selection to the extent of retinal damage is essential for optimizing surgical outcomes.
- Careful consideration of tamponade properties is necessary to balance efficacy and complication rates.
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