Artikel
Classification and management of intraocular foreign bodies according to their localisation
Suche in Medline nach
Autoren
Veröffentlicht: | 18. Juni 2008 |
---|
Gliederung
Text
Purpose: Ocular trauma due to intraocular foreign bodies (IOFBs) remains a major cause of visual loss. Three-port pars plana vitrectomy is a standard procedure to remove IOFBs. This operation may be complicated with retinal detachment and proliferative vitreoretinopathy (PVR), which are poor prognostic factors. The purpose of our study was to assess whether the surgical approach in respect to the localization of IOFBs can alter the rate of postoperative complications and improve the outcome in these patients.
Methods: 106 patients who underwent vitrectomy and removal of posterior segment IOFBs were included in the study. Visual acuity and clinical assessment were recorded pre- and post-operatively. The position of IOFBs related to retina, surgical management and complications were also documented. During vitrectomy we identified 3 groups according to the position of the IOFB to the retina: IOFB were located in the vitreous cavity (group 1), IOFB after causing retinal trauma was floating into the vitreous (group 2), IOFB was embedded in the retina (group 3).
Results: From the 106 patients 24 patients (23 %) were in group 1, 48 patients (45%) were in group 2 and 33 patients (31 %) were in group 3. Posterior vitreous detachment was induced in 10 patients in group 2 (21 %) and in 7 patients in group 3 (21 %). The rate of intraoperative and postoperative complications (retinal tears, PVR) was higher in group 2 (62%) and in group 3 (78 %). There was a significant association between poor visual outcome and the postoperative development of a retinal detachment and proliferative vitreoretinopathy.
Conclusion: The findings of this study indicate that classification of the IOFBs location in the posterior segment after ocular trauma is particularly important for the optimal management of these patients.