gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Visual prognosis for posterior segment foreign bodies after vitrectomy

Meeting Abstract

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  • corresponding author T.U. Krohne - Department of Vitreoretinal Surgery, Center of Ophthalmology, University of Cologne
  • B. Kirchhof - Department of Vitreoretinal Surgery, Center of Ophthalmology, University of Cologne
  • A.M. Joussen - Department of Vitreoretinal Surgery, Center of Ophthalmology, University of Cologne

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogP 195

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Veröffentlicht: 22. September 2004

© 2004 Krohne et al.
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Gliederung

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Objective

To evaluate long-term prognosis and late complications following vitrectomy after injury by posterior segment foreign bodies.

Methods

We performed a retrospective hospital-based study on 41 consecutive cases of intraocular foreign body (IOFB) injuries treated at our hospital over a period of 4 years (1999-2002). Only cases of foreign bodies in the posterior eye segment and removal by pars plana vitrectomy were included while cases of additional globe rupture were excluded. Mean follow-up time was 24 months (range 5-52).

Results

On admission, endophthalmitis was present in 10% of patients and retinal detachment in 7%. A retinal impact lesion was detectable in 100% of cases and direct damage to macula or optic nerve head in 17%. During postoperative follow-up, retinal detachment developed in 27%, proliferative vitreoretinopathy (PVR) in 20%, ocular hypotension in 12%, ocular hypertension in 2%, and phthisis bulbi in 5%. At final examination visual function was above/equal to 20/40 in 23% and below/equal to 20/200 in 44% of patients. Factors significantly associated with poor visual outcome included poor VA on admission (p<0.05), maculo-papillary IOFB impact (p<0.05) and PVR (p<0.01). 93% of patients received vitrectomy within 8 days following injury. Comparing vitrectomies performed on day 1-4 and on day 5-8 there was no significant difference in long-term results.

Conclusions

Following posterior segment foreign body injuries, PVR and retinal detachment were the most common postoperative complications in the examined patients. About half the patients recovered long-term visual function above 20/200. Initial visual function and IOFB impact site were predictive for visual prognosis. Development of PVR was the main postoperative risk factor for poor visual outcome. The timing of vitrectomy within the first 8 days following injury had no significant influence on the long-term prognosis.