Summary:
Objective: To demonstrate two eyes of two patients with a penetrating injury by
an organic intraocular foreign body (CNT), to outline the course of treatment and
to evaluate anatomical and functional results.
Material and methods: During the period between May and July 1999 the authors
treated at their department an 11-year-old girl and a 17-year old boy with a penet-
rating CNTinjury of organic origin. In the girl they extracted a CNTwhich pierced
the sclera and protruded into the vitreous body. The foreign body was extracted
by means of a forceps, the site of perforation was treated by a cryosurgical
procedure with a radial Silastic filling. The man was shot into the OL by a grain
of pepper froman air-gun. The organic body in the vitreous body caused a violent
inflammatory reaction in the vitreous body and retina. Early extraction of the
CNT could not be made because of an adverse corneal finding which made surgery
impossible. The progressing proliferative vitreoretinopathy (PVR) led to repeated formation of epiretinal, subretinal and cyclitic membranes which caused relap-
sing detachment of the retina (OS). The foreign body was extracted during pars
plana vitrectomy (PPV) by the transvitreal route using a forceps. Definite adhe-
rence of the retina was achieved during the third PPV, membranectomy and
implantation of silicone oil (SO). Final functional success was achieved by elimi-
nating SO and by partial perforating keratoplasty.
Results: The CNT in the girl was histologically and parasitologically identified as
a fibre of animal origin (animal hair or human eyelash). The follow up period is
six months, VOP-5/5 nat., NOT 17 torr, bulbus undisturbed. In the second patient
the cultivation finding from the vitreous body was negative. Extensive PVR
developed as a result of breakdown products of the organic CNT and led to
relapsing OS. Three months after the last operation the bulbus is at rest, the
corneal disc clear, the retina attached, VOL-3/60 s + 8.0 D steop., NOT 12 torr.
Conclusions: The final results of treatment of severe devastating penetrating
injuries bya CNTis determinedbythe preoperative condition of the ocular tissues.
CNT of organic origin damage intraocular tissues by their breakdown products
as well as by morefrequent contamination with pathological microorganisms. Our
experience provided evidence that penetrating injuries by non-infected CNT of
organic origin have a favourable prognosis. But even relapsing and prolonged OS
after extraction of the CNT of organic origin and endophthalmitis need not lead
to loss of the eye or its function.
Key words:
intraocular foreign body of organic origin, endophthalmitis
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