Citation

Zhang Y, Zhang M, Jiang C, Qiu HY. Am. J. Ophthalmol. 2011; 152(1): 66-73.e1.

Affiliation

Department of Ophthalmology, Chinese People's Liberation Army General Hospital, Beijing, China.

Copyright

(Copyright © 2011, Elsevier Publishing)

DOI

10.1016/j.ajo.2011.01.014

PMID

21529762

Abstract

PURPOSE: To investigate epidemiologic and clinical characteristics, prognostic factors, and visual outcomes of posttraumatic intraocular foreign body (IOFB). DESIGN: Retrospective, consecutive case series. METHODS: Information from 1421 eyes (1299 inpatients) with IOFB selected from all open-globe injury cases (4968 eyes of 4865 inpatients) in 15 tertiary hospitals in China over a 5-year period were collected from a standardized preformulated database of eye injuries. Factors affecting retinal lesions or detachment, development of endophthalmitis, and visual outcome were analyzed statistically. RESULTS: IOFBs represented 28.60% of all open-globe injuries. Of the 1421 eyes, endophthalmitis developed in 232 (16.76%), and independent protective factors included primary repair within 24 hours (odds ratio [OR], 0.59; P = .006) and self-sealing wounds (OR, 0.69; P = .013). At discharge or follow-up, the enucleation rate was 7.53%, best-corrected visual acuity (VA) improved in 54.33%, and 4.85% had no light perception. Wound length of at least 3 mm and IOFB located in the posterior segment increased the risk of retinal lesion or detachment, and both (OR, 1.66; P < .001; OR, 4.04; P < .001) were significant negative predictors for visual outcome, along with wound larger than IOFB in largest length (OR, 2.38; P = .002) and endophthalmitis (OR, 2.01; P = .0003). Better initial VA (OR, 0.76; P < .001) was a protective factor for final VA. CONCLUSIONS: For IOFBs, primary wound closure by repair within 24 hours or self-sealing independently reduces the risk of endophthalmitis. Worse presenting VA, larger wounds, IOFB in posterior segment, wound larger than IOFB in largest length, and endophthalmitis predict worse visual outcome.

Language: en