Summary:
Goal: The aim of this study was to establish anatomical and functional results of
combined injuries of the anterior and posterior segment of the eye caused by
penetration of the metallic foreign body.
Material and methods: The group consisted of 25 eyes with penetrating injury
caused by metallic intraocular body. The age at time of the injury in the group was 14–68 years (36.8 ∈ 10.9) and the average follow up period was 21.0 ∈ 10.7
months. All injuries were treated by means of suture of the entering wound
with immediate or postponed treatment of the pathologic findings in both
segments during one or more procedures. The metallic foreign bodies were
extracted with forceps or endomagnetic device during the pars plana
vitrectomy.
Traumatic changes of the retina were treated by means of endodiathermy and
endolaser. Silicone oil tamponade was performed, where indicated. The partial
or total traumatic cataract was removed by phacoemulsification through the
scleral admittance or by endophaco fragmentation with or without intraocular
lens implantation.
Results: The most common pathological findings were the penetrating wound of
the cornea (72 %) and traumatic changes of the iris (56 %). The total cataract
was present in 56 % of cases. In the posterior segment, vitreous hemorrhage was
most frequent (36 %). Signs of endophtalmitis were present in 12 % of cases. The
period between the primary suture and combined procedure at the anterior
and posterior segment was mostly 5–14 days (56 %). In ten cases (40 %), the
intraocular lens (IOL) was implanted, 9 times in the posterior and once in the
anterior chamber. Out of the early postoperative complications, the fibrin in the
anterior chamber was noticed most frequently (16 %), and out of the late ones,
the retinal detachment (32 %) and proliferative vitreoretinopathy (24) were
most common.
Conclusion: Anatomical and functional result of the combined injury with the
foreign intraocular body depends not only on the choice of the surgical
technique, but predominantly on the extent of the initial injury and risk of the
present infection’s spreading.
Key words:
penetrating injury, metallic intraocular foreign body
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