Management of Intraocular Foreign Bodies of the Posterior Segment to Maximize Anatomical and Functional Outcomes

2021 ◽  
pp. 333-340
Keyword(s):  
Functional Outcomes ◽  
Foreign Bodies ◽  
Vision Loss ◽  
Crystalline Lens ◽  
Posterior Segment ◽  
Special Treatment ◽  
Open Globe Injury ◽  
Open Globe ◽  
Treatment Considerations ◽  
Complicated Situation

Open globe injury (OGI) repair remains one of the most challenging surgeries in all of the eye surgery. Intraocular foreign bodies (IOFBs) constitute a subset with special treatment considerations. It is also clear that these operations can create a more complicated situation due to damage to the cornea or crystalline lens to ensure the safe removal of the posterior segment IOFBs. In these operations, indications, time, and surgical technique of removal of the IOFB should be planned in detail to maximize anatomical and functional success and prevent permanent vision loss of the patient. Several controversies exist in the management of IOFBs that will be reviewed in this article.

scholarly journals Posterior segment intraocular foreign body with secondary retinal detachment in a phakic eye: a case report

2020 ◽  
Vol 8 (5) ◽  
pp. 375-378
Author(s):  
Dr. Amit C Porwal ◽  
◽  
Dr. Hardik Jain ◽  
Dr. Pratik Mahajan ◽  
◽  
...  
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Retinal Detachment ◽  
Visual Loss ◽  
Foreign Bodies ◽  
Vitreoretinal Surgery ◽  
Crystalline Lens ◽  
Posterior Segment ◽  
Intraocular Foreign Body ◽  
Current Case

Intraocular foreign bodies (IOFBs) are an important cause of visual loss. The current case describesa case of retained intraocular foreign body with secondary retinal detachment in a phakic eye in a38-year-old man. The foreign body was safely removed through the sclerotomy port withouttouching the crystalline lens. The current case report wanted to show the anatomic and visualoutcomes of vitreoretinal surgery in such cases.

Primary Combined Pars Plana Vitrectomy and Phacoemulsification With Anterior Segment Removal of Posterior Segment Intraocular Foreign Bodies: A 30-Month Longitudinal Study

2018 ◽  
Vol 2 (2) ◽  
pp. 79-86
Author(s):  
Razek Georges Coussa ◽  
Fares Antaki ◽  
Ali Dirani ◽  
Thomas Cordahi ◽  
Radwan Ajlan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Foreign Bodies ◽  
Anterior Segment ◽  
Posterior Segment ◽  
Long Term Results ◽  
Open Globe ◽  
Pars Plana

Purpose: To describe a surgical technique and report visual and anatomical outcomes after primary combined pars plana vitrectomy (PPV) and phacoemulsification in patients with posterior segment intraocular foreign bodies (IOFBs) removed via the anterior chamber without enlarging preexisting sclerotomies. Posterior IOFBs are generally managed in a stepwise surgery consisting of phacoemulsification/lensectomy for traumatic cataract removal then PPV and removal of IOFB through enlarged sclerotomies. Enlarged sclerotomies may carry a significant risk of hypotony, vitreous hemorrhage, vitreous and retinal incarceration, and rhegmatogenous retinal detachment with proliferative vitreoretinopathy. Limited studies exist on long-term results of primary anterior segment removal of posterior IOFB combined with primary phacoemulsification. Methods: Medical records of consecutive patients who had ocular lacerations and posterior segment IOFB between October 2003 and June 2017 in a university hospital were reviewed. Patients who received a combined primary IOFB removal and phacoemulsification were included in the study. The postoperative evolution including visual acuity and complications were all recorded. Results: Thirteen patients (13 eyes) were included in the study. All patients were men, and the average age at presentation was 38 years. All IOFB were metallic, and their size ranged from 2 to 7 mm. All patients were operated within 24 hours of presentation. Six (46%) of the 13 lacerations were corneal, and 7 (54%) were scleral. Overall, 9 of 13 (69%) had a final postoperative best-corrected visual acuity equal to or better than 20 of 25. There were 3 (23%) postoperative complications of recurrent rhegmatogenous retinal detachment that occurred within the first postoperative year. Conclusion: Primary combined PPV and phacoemulsification with the removal of IOFB via the anterior segment is a safe and promising approach for repairing open globe injuries. Our results demonstrate the favorable prognostic benefit of this technique, which is recommended in cases with small corneal laceration and posterior segment pathology resulting from IOFB.

Blast Eye Injuries: A Review for First Responders

2010 ◽  
Vol 4 (2) ◽  
pp. 154-160 ◽  
Author(s):  
Michael G. Morley ◽  
Jackie K. Nguyen ◽  
Jeffrey S. Heier ◽  
Bradford J. Shingleton ◽  
Joseph F. Pasternak ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Foreign Bodies ◽  
Vision Loss ◽  
Injured Patient ◽  
Ocular Injury ◽  
Blast Injuries ◽  
Care Providers ◽  
Eye Injuries ◽  
Open Globe ◽  
Severe Vision Loss

ABSTRACTAs the rate of terrorism increases, it is important for health care providers to become familiar with the management of injuries inflicted by blasts and explosions. This article reviews the ocular injuries associated with explosive blasts, providing basic concepts with which to approach the blast-injured patient with eye trauma. We conducted a literature review of relevant articles indexed in PubMed between 1948 and 2007. Two hundred forty-four articles were reviewed. We concluded that ocular injury is a frequent cause of morbidity in blast victims, occurring in up to 28% of blast survivors. Secondary blast injuries, resulting from flying fragments and debris, cause the majority of eye injuries among blast victims. The most common blast eye injuries include corneal abrasions and foreign bodies, eyelid lacerations, open globe injuries, and intraocular foreign bodies. Injuries to the periorbital area can be a source of significant morbidity, and ocular blast injuries have the potential to result in severe vision loss.(Disaster Med Public Health Preparedness. 2010;4:154-160)

scholarly journals The role of various imaging techniques in identifying and locating intraocular foreign bodies related to open-globe injury: three case reports and literature review

Medwave ◽  
2020 ◽  
Vol 20 (01) ◽  
pp. e7772-e7772
Author(s):  
Diego Valera-Cornejo ◽  
Marlon García-Roa ◽  
Paulina Ramírez-Neria ◽  
Yolanda Villalpando-Gómez ◽  
Verónica Romero-Morales ◽  
...  
Keyword(s):  
Literature Review ◽  
Foreign Bodies ◽  
Imaging Techniques ◽  
Case Reports ◽  
Open Globe Injury ◽  
Open Globe

scholarly journals Impacted iron nail in the orbit and maxillary sinus through a corneo-scleral perforation: a case report

2013 ◽  
Vol 5 (2) ◽  
pp. 268-271 ◽  
Author(s):  
Ranju Kharel Sitaula ◽  
V Gautam ◽  
Krishna KC ◽  
DN Shah
Keyword(s):  
Maxillary Sinus ◽  
Foreign Bodies ◽  
Open Globe Injury ◽  
Open Globe ◽  
Impacted Foreign Body ◽  
History Of ◽  
The Right ◽  
Perforating Injury ◽  
Two Stages ◽  
Tomography Scan

Introduction: Open globe injury is one of the commonest ophthalmic emergencies, and when accompanied by intraocular foreign bodies, the condition carries a poorer prognosis. Objective: To report a rare case of perforating injury of the globe with an iron nail which got lodged in the maxillary sinus. Case: A ten-year-old boy presented with the history of sudden painful loss of vision in his right eye. He reported that he was hit forcefully by the tail of a cow a day before the presentation. There was no perception of light in that eye. The ocular examination revealed a full thickness corneo-scleral perforation with prolapsed uveal tissue. The X-ray of the right orbit showed an impacted foreign body in the inferior orbit and computed tomography scan of the orbit confirmed the presence of a vertically impacted metal piece in the right orbit and right maxillary sinus. The repair of the perforation and removal of the impacted nail was done in two stages. The globe anatomy was maintained but the vision could not be restored due to the grave nature of the trauma. Conclusion: Perforating globe injury is an important cause of monocular blindness. Nepal J Ophthalmol 2013; 5(10): 268-271 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8742

scholarly journals Internal Limiting Membrane Peeling versus Nonpeeling to Prevent Epiretinal Membrane Formation following Vitrectomy for Posterior Segment Open-Globe Injury

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Wen-Long Wei ◽  
Zhong Lin ◽  
Ming-Na Xu ◽  
Ke-Mi Feng ◽  
Zhen-Quan Zhao
Keyword(s):  
Visual Acuity ◽  
Confidence Interval ◽  
Epiretinal Membrane ◽  
Odds Ratio ◽  
Internal Limiting Membrane ◽  
Posterior Segment ◽  
Open Globe Injury ◽  
Ilm Peeling ◽  
Open Globe ◽  
Surgical Data

Purpose. Approximately 30% of patients with an open-globe injury (OGI) develop a secondary epiretinal membrane (ERM). This study was performed to assess whether internal limiting membrane (ILM) peeling in the treatment of posterior segment OGI prevents ERM formation. Methods. The medical records of 33 patients who underwent vitrectomy for posterior segment OGI from 2016 to 2019 were retrospectively analyzed. Of these patients, 17 underwent ILM peeling during the vitrectomy and 16 did not. The patients’ demographic and surgical data were collected. The associations of ILM peeling with the preoperative findings of posterior segment OGI and development of a postoperative ERM were analyzed. Student’s t-test was used to evaluate differences in continuous variables, and the chi-squared test or Fisher’s exact test was used for categorical variables. Time-to-event curves were calculated from postestimation Cox proportional hazards models. Results. An ERM developed in three eyes (17.6%) in the ILM peeling group and in eight eyes (50.0%) in the nonpeeling group ( p < 0.05 ). There was no statistically significant difference between the groups in visual acuity at baseline (1.68 vs. 1.58 logMAR, p = 0.68 ) or at final follow-up (0.72 vs. 0.78 logMAR, p = 0.66 ). Median visual acuity significantly improved in both groups ( p < 0.001 ). In the multivariable models, ILM peeling (odds ratio, 0.19; 95% confidence interval, 0.04–0.91; p = 0.04 ) and worse preoperative vision (odds ratio, 0.29; 95% confidence interval, 0.10–0.80; p = 0.02 ) were associated with lower likelihood of ERM formation. Conclusion. Preventative treatment with ILM peeling contributed to decreased development of an ERM in patients with OGI involving areas near the fovea.

scholarly journals Open Globe Injury in a Tertiary Care Hospital

2018 ◽  
Vol 16 (2) ◽  
pp. 62-65
Author(s):  
Bikram Bahadur Thapa ◽  
Dabal Bahadur Thapa ◽  
Har Karan Nath
Keyword(s):  
Visual Acuity ◽  
Primary Repair ◽  
Tertiary Care ◽  
College Teaching ◽  
Posterior Segment ◽  
Care Hospital ◽  
Open Globe Injury ◽  
Young Males ◽  
Medical College ◽  
Open Globe

Introduction: Open Globe Injury (OGI) is a type of mechanical eye injury in which there is a full thickness defect of the outer fibrous coat of eye ball. The Prognosis in the eyes with OGI has improved in these days. 2.4% of blindness in Nepal was due to ocular trauma in 1981. The aim of this study was to describe epidemiological profile, clinical profile and treatment outcome in eyes with open globe injury. Methodology: It is the prospective interventional non randomized hospital based study on the patients of open globe injury presented to the Nepalgunj Medical College, Nepalgunj from April 2017 to May 2018. Visual acuity, anterior and posterior segment evaluation, site and size of wound were recorded. All the eyes were underwent primary repair surgery. Postoperative visual acuity, anterior and posterior segment evaluation was carried out on all follow up. Second surgery was done if required. Results: 0.4% of ophthalmic and 0.016% of all hospital patients had open globe injury. Most of the victims were young males. The mean age of study population was 10.98±17.1 year. Playing (62.5%) was the most common time of injury and wooden stick (50%) was most common agent of injury. Zone I involvement (87.5%) and penetrating type (91.7%) was found in most of cases. 87.5% of eyes were blind, 4.2%were visually impaired and 8.3% had normal vision at the time of presentation. 79.2 % of eye were improved after treatment on visual function, 12.5% remained unchanged while 8.3% deteriorates and leads to pthysis bulbi. Conclusion: The incidence of open globe injury was 0.4% among ophthalmic patients and 0.016% among all patients of Nepalgunj Medical College Teaching Hospital, Nepalgunj. Early Primary repair, use of systemic antibiotics and postoperative care provides encouraging anatomical and functional outcome in these eyes with OGI.

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