Abstract
Purpose: Analysis of traditional versus comprehensive management techniques for eyes with ferrous IOFBs in the posterior segment. Patients and methods: Retrospective review of 30 eyes undergoing IOFB removal by EM and of 34 eyes managed by PPV techniques. Results: Vitreous hemorrhage occurred commonly (EM group: 40%, PPV group: 50%). Only in the EM group did the intervention cause iatrogenic vitreous hemorrhage (23%) and has post extraction endophthalmitis developed (10%). Vision improved in 23% of eyes, deteriorated in 53%; >0.5 vision was achieved in 20%. Five EM eyes (17%) were anatomically lost; PVR developed in 48% of the remaining eyes. In the PPV group, no eye was anatomically lost and PVR developed in 12%. Vision improved in 68% of eyes, deteriorated in 15%; >0.5 vision was achieved in 68%. A single retinal impact site occurred in 71%, ≤2 impact sites in 21% of eyes. Conclusions: Approximately one of two eyes with posterior segment IOFB develops vitreous hemorrhage, over two-thirds sustain at least one retinal lesion, and one-fifth of eyes suffer multiple retinal injuries. Both the anatomical (p = 0,003) and the functional (p = 0,005) prognoses are significantly better in eyes undergoing PPV compared to eyes with EM use. Timely PPV appears to markedly reduce the risk of endophthalmitis development. These results confirm the need to abandon the EM and perform PPV for eyes with posterior segment IOFBs.
Similar content being viewed by others
References
Duke−Elder S. System of Ophthalmology. Vol. XIV. London: Henry Kimpton, 1972: 451.
Roper−Hall MJ. Review of 555 cases of intra−ocular foreign bodies with special reference to prognosis. Br J Ophthalmol 1954; 38: 65–99.
Nuranen M. Perforating eye injuries. Acta Ophthalmol (Suppl) 1978; 135: 1–87.
Percival SPB. Late complications from posterior segment intraocular foreign bodies. Br J Ophthalmol 1972; 56: 462–468.
Amalong RJ. Retinal detachment after manipulation of magnetic foreign body. Am J Ophthalmol 1970; 70: 10–13.
Chiquet C, Zech J, Gain P, et al. Visual outcome and prognostic factors after magnetic extraction of posterior segment foreign bodies in 40 cases. Br J Ophthalmol 1998; 82: 801–806.
Chiquet C, Zech J, Denis P, et al. Intraocular foreign bodies. Factors influencing final visual outcome. Acta Ophthalmol 1999; 77: 321–325.
Williams DF, Mieler WF, Abrams GW, Lewis H. Results and prognostic factors in penetrating ocular injuries with retained intraocular foreign bodies. Ophthalmology 1988; 95: 911–916.
Kazokoglu H, Saatci O. Intraocular foreign bodies: results of 27 cases. Ann Ophthalmol 1990; 22: 373–376.
Hadden OB, Wilson JL. The management of intraocular foreign bodies. Austr NZJ Ophthalmol 1990; 18: 343–351.
Pavlovic S, Schmidt KG, Tomic Z, Dzinic M. Management of intra−ocular foreign bodies impacting or embedded in the retina. Austral NZJ Ophthalmol 1998; 26: 241–246.
Punnonen E, Laatikainen L. Prognosis of perforating eye injuries with intraocular foreign bodies. Acta Ophthalmol 1989; 66: 483–491.
Kuhn F, Heimann K. Ein neuer Dauermagnet zur Entfernung intraokularer ferromagnetischer Fremdkoerper. Klin Mbl Augenheilk 1991; 198: 301–303.
Kuhn F, Halda T, Witherspoon CD, et al. Intraocular foreign bodies: myths and truths. Eur J Ophthalmol 1996; 6: 464–471.
De Bustros S. Posterior segment intraocular foreign bodies. In: Shingleton BJ, Hersh PS, Kenyon KR (eds). Eye trauma. St. Louis: Mosby – Year Book, Inc., 1991; 232.
Campochiaro PA, Gaskin HC, Vinores SA. Retinal cryopexy stimulates traction retinal detachment in the presence of an ocular wound. Arch Ophthalmol 1987; 1567–1570.
Ahmadieh H, Sajjadi H, Azarmina M. Surgical management of intraretinal foreign bodies. Retina 1994; 14: 397–403.
Behrens−Baumann W, Praetorius G. Intraocular foreign bodies. Ophthalmologica 1989; 198: 84–88.
Camacho H, Mejia LF. Extraction of intraocular foreign bodies by pars plana vitrectomy. Ophthalmologica 1991; 202: 173–179.
Cooling RJ, McLeod D, Blach RK, Leaver PK. Closed microsurgery in the management of intraocular foreign bodies. Trans Ophthalmol Soc UK 1981; 181–183.
Khan MD, Kundi N, Mohammed Z, Nazeer AF. A 6 l/2−years survey of intraocular and intraorbital foreign bodies in Northwest Frontier Province, Pakistan. Br J Ophthalmol 1987; 71: 716–719.
Cleary PE, Ryan SJ. Method of production and natural history of experimental posterior penetrating eye injury in the rhesus monkey. Am J Ophthalmol 1979; 88: 212–220.
Cleary PE, Ryan SJ. Histology of wound, vitreous, and retina in experimental posterior penetrating eye injury in the rhesus monkey. Am J Ophthalmol 1979; 88: 221–231.
Cleary PE, Ryan SJ. Vitrectomy in penetrating eye injury. Arch Ophthalmol 1981; 99: 287–292.
Souza DS, Howcroft M. Management of posterior segment intraocular foreign bodies: 14 years’ experience. Can J Ophthalmol 1999; 34: 23–29.
Thompson JT, Parver LM, Enger CL, et al. Infectious endophthalmitis after penetrating injuries with retained intraocular foreign bodies. Ophthalmology 1993; 100: 1468–1474.
Witherspoon C, Morris R, Goggans W. Automated regulation of fluid infusion pressure during vitrectomy. Arch Ophthalmol 1986; 104: 1551.
Coleman DJ, Lucas BC, Rondeau MJ, Chang S. Management of intraocular foreign bodies. Ophthalmology 1987; 1647–1653.
Rosner M, Bartov E, Treister G, Belkin M. Prophylactic scleral buckling in perforating ocular injuries involving the posterior segment. Ann Ophthalmol 1988; 20: 146–149.
Heimann K, Paulmann H, Tavakolian U. The intraocular foreign body. Int Ophthalmol 1983; 6: 235–242.
Slusher MM, Sarin LK, Federman JL. Management of intraretinal foreign bodies. Ophthalmology 1982; 89: 369–373.
Williams DF, Mieler WF, Abrams GW. Intraocular foreign bodies in young people. Retina 1990; 10: S45–49.
Kuhn F, Morris R, Witherspoon C, King W. Percentage scattergram to depict changes in large amounts of data over time. Ophthalmic Epidemiology 1995; 2: 45–48.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mester, V., Kuhn, F. Ferrous intraocular foreign bodies retained in the posterior segment: management options and results. Int Ophthalmol 22, 355–362 (1998). https://doi.org/10.1023/A:1006487313380
Issue Date:
DOI: https://doi.org/10.1023/A:1006487313380