Intraocular foreign bodies in the posterior segment: Clinical characteristics, management, and visual outcomes

To analyze the clinical characteristics, management, and visual outcomes of patients with retained posterior segment intraocular foreign bodies (IOFBs).

This was a retrospective, non-comparative, single-institutional case series conducted in a tertiary care center in North India, enrolling 17 patients with penetrating eye injuries and retained posterior segment IOFBs. Ocular evaluation included best corrected visual acuity (BCVA), slit lamp biomicroscopy, indirect ophthalmoscopy, and preoperative ultrasonography for poor media clarity. All patients underwent 23-gauge pars plana vitrectomy for IOFB removal, which was achieved using diamond-coated forceps or a magnet. Statistical analysis included both parametric and non-parametric tests, with p < 0.05 considered significant.

The mean age of patients was (34.0 ± 10.9) years, with 94% being males. Construction-related work was the most common cause of trauma (41%). Metallic IOFBs accounted for 76.4% of cases, with a mean size of (4.85 ± 3.52) mm. Traumatic cataracts (70.5%) and vitreous haemorrhage (70.5%) were frequently observed. Anatomical and functional success was achieved in 94% of cases. Preoperative BCVA (2.37 ± 0.74 logMAR) showed a statistically significant improvement postoperatively (1.32 ± 0.81 logMAR). Initial poor BCVA (p < 0.001), delayed surgery (p = 0.016), and a retinal IOFB location (p = 0.023) were associated with significantly worse visual outcomes.

Despite the severity of penetrating trauma involving IOFBs, prompt management with pars plana vitrectomy yielded a high rate of successful anatomical and functional outcomes. However, initial poor visual acuity, delayed surgery (beyond 48 h), and retinal IOFBs are significant predictors of a poorer prognosis. A proactive approach involving early intervention and preventive measures, such as protective eyewear, is highly recommended.