Prognosis of perforating eye injuries with intraocular foreign bodies

The long-term results of 95 consecutive eyes with a perforating eye injury and an intraocular foreign body (IOFB) treated with or without pars plana vitrectomy are reported. With the mean follow-up time of 30.0 months (median 22.8 months) 10 eyes (11%) were enucleated and another 17% became blind (visual acuity less than 0.05). The enucleation rate was considerably decreased and the visual outcome improved as compared with previous studies in Finland. The visual outcome was affected unfavourably by posterior location of the perforation, blunt injury, prolapse of intraocular tissue and poor initial visual acuity. There was no significant difference in the visual outcome between eyes with posterior segment IOFBs treated with or without vitrectomy. In the posterior perforation group the visual outcome was slightly better in eyes in which vitrectomy was performed (P = 0.336), and early vitrectomy within 1 week gave best visual results (P = 0.692). In 79% of the non-enucleated eyes the retina was attached. The anatomic success rate was similar regardless of the timing of vitrectomy.