Intraocular foreign bodies in china: clinical characteristics, prognostic factors, and visual outcomes in 1,421 eyes

Am J Ophthalmol. 2011 Jul;152(1):66-73.e1. doi: 10.1016/j.ajo.2011.01.014. Epub 2011 May 6.

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 1,421 eyes (1299 inpatients) with IOFB selected from all open-globe injury cases (4,968 eyes of 4,865 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 1,421 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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • China / epidemiology
  • Endophthalmitis / epidemiology
  • Eye Enucleation / statistics & numerical data
  • Eye Foreign Bodies / epidemiology*
  • Eye Foreign Bodies / physiopathology
  • Eye Foreign Bodies / surgery
  • Eye Injuries, Penetrating / epidemiology*
  • Eye Injuries, Penetrating / physiopathology
  • Eye Injuries, Penetrating / surgery
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Visual Acuity / physiology*
  • Young Adult