Summary:
Background: A penetrating eye injury due to an intraocular foreign body (IOFB)
may result in a poor vision and even in loss of the eye. A proper analysis of the
cause of injury and of the injured eye enables a correct decision to be made
concerning timing and method to be used not only for foreign body removal but
also concerning of all sight saving surgical procedures.
Patients and methods: Over the years 1989 - 1993, 51 patients with an IOFB in the
posterior segment of the eye were treated at the Department of Ophthalmology
of the Comenius University in Bratislava. One patient was lost from the long-term
observation and in two patients was an intraocular foreign body not removed. We
evaluate results in 48 patients. The operative techniques used by foreign body
removal and by reoperations are mentioned. The occurrence of peroperative and
postoperative complications and the final anatomical and functional results are
evaluated. An average follow-up period was 40.7 months. The value of the following
prognostic factors was considered in relation to the final visual acuity: size and location of the laceration of the eye, size of IOFB and time of IOFB removal. The
statistical significance was tested by Chí-square. Fischer’s coefficient for tetra-
choric tables was used for the calculation of power of dependence.
Results: The foreign body was removed from 64,6% of the eyes after pars-plana
vitrectomy. Foreign body caused serious damage of the intraocular structures in
37,5 % of the eyes. The poor anatomical result was achieved in 18 (37.5%) and good
in 30 eyes (62.5%). In twelve eyes (25%) was implanted an IOL. The final visual
acuity of 6/9 - 6/6 was achieved in 18 (37.5%) and visual acuity lower than 2/60 was
recorded in 21 (43.7%) of the eyes. The prediction of bad visual acuity (lower than
2/60) was significant related to: all lacerations except of corneal wounds smaller
than 4 mm, IOFB size exceeding 3x2 mm.
Conclusions: Management of retained intraocular foreign bodies should be indi-
vidual and is dependent on the extent of the initial injury and the characteristics
and location of the IOFB. The final outcome depends mostly on the extent of the
primary injury and of the occurence of the peroperative and postoperative
complications.
Key words:
intraocular foreign body, posterior segment of the eye, prognosis
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