Intraocular Foreign Bodies: Visual Outcome and Prognostic Factors

Purpose: To evaluate and highlight the prognostic factors that might predict the final visual outcome in trauma cases presenting with penetrating metallic IOFBs. Patients and Methods: 26 eyes were included in our study. The IOFB was successfully removed from 24 eyes and could not be located in 2 eyes in spite of presence in the CT scan images. In all cases a complete pars plana vitrectomy was performed with removal of the IOFB either with the FB forceps or with the intraocular magnet. Cataract extraction was performed in opaque or injured lenses with or without IOL implantation as needed. Results: The follow-up period ranged from 6 to 38 months. The final BCVA ranged from LP to 6/12. Sixteen patients (61%) had a final BCVA of 6/24 or better, 6 patients (23%) had a BCVA of 1/60 or better, 2 patients (7.6%) had a final BCVA of HM and 2 patients (7.6%) ended by LP due to a severe PVR in one eye and macular impact by the FB in the other eye. Good visual results were usually obtained in eyes with absent central corneal entry wounds, no associated iris or choroidal tissue prolapse, small size of FB, no retinal detachment and no macular injury. Traumatic cataract was not an important prognostic issue as a lens implantation was usually possible either primarily or at a later stage. Conclusion: In conclusion, penetrating eye trauma is a devastating condition in which prevention can save many eyes. Timely intervention by modern microsurgical techniques including pars plana vitrectomy and removal of the IOFB gives good results, and visual outcome is even better when there is no associated retinal detachment and no uveal tissue prolapse.