Open-Globe Injury With Intraocular Foreign Body

Abstract

Purpose: To investigate characteristics of Open Globe Injuries (OGI) that presented with Intra-Ocular Foreign Body (IOFB), along with their long-term visual outcomes and complications. Methods: Retrospective interventional consecutive case series of OGIs with IOFBs that presented at Massachusetts Eye and Ear from 2010 to 2015. Data collected included time from injury to OGI repair, location of IOFB, retinal detachment (RD) rate, presenting and final visual acuity and subsequent surgeries. Results: Fifty-seven consecutive cases of OGIs with IOFBs were included. Mean follow-up was 28 months and median time from injury to OGI repair was 0 days. Overall, 38/57 (66.7%) eyes achieved final vision of 20/40 or better and 43/57 (75.4%) 20/150 or better. Thirty-three cases had IOFBs in the anterior segment only, 24 cases had posterior segment involvement. Thirty percent of cases (17/57) were complicated by an RD, 58.3% (14/24) in the posterior versus 9.1% (3/33) in the anterior IOFB group ( P = .01). There were no cases of endophthalmitis. Posterior IOFB and higher zone of injury were risk factors for RD both at presentation (both P < .001) and post-primary repair (both P < .001). Posterior IOFB was associated with higher vitrectomy rates both at presentation ( P < .001) and post-primary repair ( P = .002) and worse long-term visual outcome ( P = .01). Conclusions: OGIs with IOFB involving the posterior segment are associated with higher complication and re-operation rates and worse visual prognosis compared to those involving the anterior segment only.