Management of intra-ocular foreign bodies impacting or embedded in the retina

Abstract

Purpose: To identify both the clinical features of eyes suffering penetrating ocular injury with intra-ocular foreign bodies (FB) impacting or embedded in the retina and the results of surgical outcome and complication rates. Methods: Thirty-eight consecutive cases of penetrating ocular injuries with intra-ocular FB impacting or embedded in the retina were retrospectively analysed. Results: The FB were metallic in 30 eyes (78.9%; 19 ferromagnetic) and were non-metallic in eight eyes (21.1%). Magnetic extraction was performed in 17 cases (44.7%) and instrumental extraction was performed in 21 cases (55.3%). In two cases, pars plana vitrectomy and FB removal was combined with penetrating keratoplasty, temporary keratoprosthesis and anterior segment reconstruction because of severe explosive injury to the eye. At the final postoperative examination, 32 eyes (84.2%) had completely attached retinas. Visual acuity (VA) improved postoperatively in 18 eyes (47.4%). A final VA of 0.5 or better was achieved in nine of 23 eyes (39.1%) with FB in the peripheral retina and in one of 15 eyes (6.7%) with posterior pole and/or optic nerve head involvement. There was no difference in the final VA regarding the time elapsed between trauma and the removal of the FB. Conclusion: The late anatomical and functional outcome in eyes with penetrating ocular injury and FB impacting or embedded in the retina is mostly uncertain, despite immediate and complex surgery. Final anatomical and functional outcome in the present study was influenced by location and extent of the initial damage to the posterior pole. The time that had elapsed between trauma and removal of the FB did not influence final visual function.