title: Ocular injuries with a metallic foreign body in the posterior segment as a result of hammering: the visual outcome and prognostic factors.
abstract: OBJECTIVE
  To evaluate the evolution of the best-corrected visual acuity (BCVA), to determine the prognostic factors, and to analyze the efficiency of the surgical procedures in the cases of ocular injuries caused by a metallic intraocular foreign body retained in the posterior segment as a result of hammering.
  
  
  METHODS
  A retrospective review of 64 consecutive patients was conducted at the Cantonal Hospital St Gallen over a 15-year period. The pre-, intra-, and postoperative clinical parameters were assessed. The statistics were performed using Fisher's exact test and a multiple correspondence analysis.
  
  
  RESULTS
  The mean initial BCVA was 20/138 (standard deviation, 20/112). The mean ocular trauma score was 3.03 (standard deviation, 0.83). In all cases, the removal of the intraocular foreign body was performed within 24 hours after the injury. In 45 patients (70.3%), further operations were performed during the mean follow-up of 54.4 months (standard deviation, 22.7 months). The mean final BCVA was 20/39 (standard deviation, 20/55). In 53 patients (82.8%), the final BCVA was 20/40 or more. In 8 patients (12.5%), the final BCVA was 20/200 or less because of a direct macular lesion caused by the intraocular foreign body (P < 0.001).
  
  
  CONCLUSIONS
  Thanks to the improvement in the surgical procedures, the ocular injuries with a metallic intraocular foreign body in the posterior segment as a result of hammering have a good visual outcome unless the macula is involved.
authors.affiliation: *Clinic of Ophthalmology; and †Clinic Unit Trial, Cantonal Hospital St Gallen, St Gallen, Switzerland; and ‡Clinic of Ophthalmology, University of Regensburg, Regensburg, Germany.
authors.forename: Christophe
authors.initials: C
authors.lastname: Valmaggia
authors.forename: Florent
authors.initials: F
authors.lastname: Baty
authors.forename: Corina
authors.initials: C
authors.lastname: Lang
authors.forename: Horst
authors.initials: H
authors.lastname: Helbig
mesh_terms: D000293:Adolescent; D000328:Adult; D005129:Eye Foreign Bodies / Q000503:physiopathology* / Q000601:surgery; D015807:Eye Injuries, Penetrating / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D057972:Posterior Eye Segment; D011379:Prognosis; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy; D057586:Vitreoretinal Surgery; D055815:Young Adult
chemical_list: D008670:Metals