Ferrous intraocular foreign bodies retained in the posterior segment: management options and results.
OBJECTIVE
Analysis of traditional versus comprehensive management techniques for eyes with ferrous IOFBs in the posterior segment.


METHODS
Retrospective review of 30 eyes undergoing IOFB removal by EM and of 34 eyes managed by PPV techniques.


RESULTS
Vitreous hemorrhage occurred commonly (EM group: 40%, PPV group: 50%). Only in the EM group did the intervention cause iatrogenic vitreous hemorrhage (23%) and has postextraction endophthalmitis developed (10%). Vision improved in 23% of eyes, deteriorated in 53%; >0.5 vision was achieved in 20%. Five EM eyes (17%) were anatomically lost; PVR developed in 48% of the remaining eyes. In the PPV group, no eye was anatomically lost and PVR developed in 12%. Vision improved in 68% of eyes, deteriorated in 15%; >0.5 vision was achieved in 68%. A single retinal impact site occurred in 71%, < or =2 impact sites in 21% of eyes.


CONCLUSIONS
Approximately one of two eyes with posterior segment IOFB develops vitreous hemorrhage, over two-thirds sustain at least one retinal lesion, and one-fifth of eyes suffer multiple retinal injuries. Both the anatomical (p = 0, 003) and the functional (p = 0, 005) prognoses are significantly better in eyes undergoing PPV compared to eyes with EM use. Timely PPV appears to markedly reduce the risk of endophthalmitis development. These results confirm the need to abandon the EM and perform PPV for eyes with posterior segment IOFBs.
Department of Ophthalmology, University of Pécs, Hungary.
V
V
Mester
F
F
Kuhn
D000293:Adolescent; D000328:Adult; D000368:Aged; D004574:Electromagnetic Fields; D009877:Endophthalmitis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005129:Eye Foreign Bodies / Q000000981:diagnostic imaging / Q000601:surgery*; D015807:Eye Injuries, Penetrating / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007501:Iron; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D012086:Reoperation; D012160:Retina / Q000293:injuries* / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body / Q000293:injuries* / Q000601:surgery; D014823:Vitreous Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery
D007501:Iron