Surgical management of intraretinal foreign bodies

To identify the clinical features in eyes with intraretinal foreign bodies (IRFBs) and evaluate the results of surgical management in these cases.

The records of 75 patients (76 eyes) with IRFBs were retrospectively reviewed. All eyes underwent vitrectomy. The IRFBs were removed with intraocular forceps in 45 eyes (59.2%) and by magnetic extraction in 31 eyes (40.8%), either through pars plana sclerotomy or through the sclera over the IRFB after precise localization. Laser photocoagulation or cryotherapy was performed around the IRFB before surgery in 38 eyes.

The average follow-up period was 34 months. Of the 75 patients, 46 (61.3%) were injured at war. The IRFBs were metallic in 71 (93.4%) eyes. Of these, 59 (83%) were ferromagnetic. In these 76 eyes, final visual acuity was 20/15-20/40 in 37 (48.6%), and 20/50-20/200 in another 10 (13%). In 19 eyes (25%), partial or total retinal detachment was present at the final follow-up examination.

Surgical management of IRFBs is a complicated procedure. The appropriate route of removal may be determined by the type and site of the embedded IRFB. Performance of a meticulous vitrectomy is mandatory, and an attempt should be made to minimize the rate of iatrogenic peripleral retinal breaks. Preoperative retinopexy around the site of the embedded foreign body is recommended, if possible, to reduce the risk of retinal detachment. The prognosis in eyes with IRFBs and rhegmatogenous retinal detachment is guarded.