Vitrectomy in the management of intraocular foreign bodies and their complications

Twenty-six eyes with intraocular foreign bodies (IOFB) and/or their sequelae were treated by pars plana vitrectomy and associated surgery. One-step removal of the IOFB in combination with pars plana vitrectomy resulted in early visual rehabilitation and minimal complications. Of 11 eyes with IOFB treated by primary vitrectomy at the time of IOFB removal 20/50 or better visual acuity was obtained in 10 (91%). Four of these eyes had retinal injury, 3 of which were successfully repaired without subsequent complication and with retention of good visual function. In 3 eyes IOFBs were not removed owing to chronic retinal encapsulation. These eyes continue to retain good visual acuity, and ERG studies show no evidence of retinal toxicity. Of 12 eyes in which vitrectomy was performed for sequelae of IOFB only 5 (41%) showed visual improvement better than 20/50. Only in 2 of 7 eyes with tractional retinal detachment could the retina be reattached. In cases of retinal injury primary vitrectomy, cryocoagulation, and scleral buckling are suggested for prevention of late traction retinal detachment.