Clinical presentations and surgical outcomes of intraocular foreign body presenting to an ocular trauma unit
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Clinical presentations and surgical outcomes of intraocular foreign body presenting to an ocular trauma unit Rodrigo Anguita 1,2 & René Moya 1,3 & Victor Saez 1 & Gaurav Bhardwaj 2,4 & Alejandro Salinas 1 & Rudolf Kobus 1 & Cristóbal Nazar 5 & Rodolfo Manriquez 1 & David G. Charteris 2 Received: 7 May 2020 / Revised: 9 July 2020 / Accepted: 23 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives To describe, evaluate, and identify the characteristics, prognostic factors, and visual outcomes in patients with intraocular foreign body (IOFB) in a Latin American population. Methods A retrospective, observational case-series of patients with a diagnosis of IOFB. Variables analyzed included age, gender, initial and final best correct visual acuity (BCVA), ocular trauma score, intraocular pressure, mechanism of injury, material and number of IOFB, zone of injury, timing of primary repair and IOFB removal, complications, and follow up. Results Sixty-one patients with IOFB were identified of which 97% were male with a mean age of 37.9 years (SD 2.16). The most common IOFB location was intravitreal (43%). IOFBs were metallic in 78%, vegetal in 3%, and other materials in 11%. Primary repair and secondary IOFB removal were performed at a mean timepoint of 3 days and 5 days, respectively. Systemic and topical antibiotics were administered to all patients. The initial BCVA was 1.62 logMAR and the final was 0.6 logMAR, which was statistically significant (Pearson’s chi-squared test, p value 0.01). No cases of endophthalmitis were seen. Conclusion IOFB removal can be delayed when there are no signs of infection or evidence of retinal detachment, without an increased risk of endophthalmitis and a negative impact on visual outcomes. Use of topical and systemic antibiotics appear sufficient to prevent endophthalmitis in these cases. Keywords Intraocular foreign body . Latin America . Ocular trauma . Retina . Vitreoretinal surgery . Traumatic endophthalmitis . Traumatic retinal detachment . Antibiotics
Introduction Intraocular foreign body (IOFB) is a serious ophthalmic emergency which can result in blindness. IOFBs account for 16– 41% of open globe injuries, and may affect visual function severely [1–3]. Young men are the most commonly affected group, usually accounting for over 90% of cases [2, 4] notably in work-related injuries without adequate protective measures. In 1993, Thompson and co-workers reported that only 6% of those who suffered IOFB were wearing protective eyewear [5]. Hammering is the most common mechanism of injury, reported to account for 43% [2]. Treatment is surgical and
* Rodrigo Anguita [email protected] 1
Hospital Del Salvador, Universidad de Chile, Santiago, Chile
2
Moorfields Eye Hospital NHS Foundation Trust, London, UK
the main objective is to achieve an effective repair of ocular anatomy, remove the IOFB, and minimize complications, in particular endophthalmitis. There is currently no published data on the outcomes of IOFB in a Latin American pop
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