gms | German Medical Science

Purpose: To asses the visual outcome and the retinal complications following vitreoretinal surgery for intraocular foreign bodies (IOFBs).

Methods: Retrospective analysis of 59 IOFBs, with different locations, removed with intraocular forceps or intraocular magnet during pars plana vitrectomy (PPV) between January 1999 and January 2008. 47 out of 59 IOFBs (79.66%) were removed immediately after primary wound closure and 12 with a delay ranging from 48 hours to 5 years. All IOFBs were metallic. Total vitrectomy with careful membrane peeling and laser photocoagulation around the retinal injury (if present) was performed. Relaxing retinotomy was necessary in 3 cases of retinal incarceration. Endotamponade with SF6 (26 cases) or silicone oil (8 cases) was performed, if needed, at the end of surgery. The average follow-up period after surgery was 17.9 month (ranging 6 – 36 months).

Results: 18 out of 59 IOFBs (30.5%) were intraretinal. 39 out of 59 eyes (66.10%) showed signs of endophthalmitis. Preoperative visual acuity ranged from light perception to 20/30. The mean visual acuity significantly increased after surgery from 20/120 preoperatively to 20/40 at the end of follow-up (range hand movements – 20/20). 51 out of 59 cases (86.44%) have stable anatomical result. A final visual acuity equal or better than 20/200 was obtained in 45 cases (76.27%). Mild retinal folding could be noticed in some cases around the laser-treated retinal injury. In 8 out of 59 cases (13.56%) visual acuity remained low or decreased due to PVR associated retinal detachment requiring additional surgery.

Conclusions: IOFBs and especially those intraretinal require a prompt and meticulous PPV. Good functional outcome appears mainly related to severity and topography of primary injury. PVR associated retinal detachment and retinal folding were the main complications observed.