PROGNOSTIC FACTORS FOR PREDICTING VISUAL OUTCOME AFTER VITRECTOMY FOR POSTERIOR SEGMENT INTRAOCULAR FOREIGN BODIES

Abstract

AIM: To analyze the prognostic factors and assess the visual outcome in patients with IOFBs treated by pars plana vitrectomy.
PATIENTS AND METHODS: This study was a prospective interventional case series of 80 consecutive eyes of patients with penetrating eye injuries and retained intraocular foreign body (IOFB) in the posterior segment who underwent IOFB removal by pars plana vitrectomy at Zagazig University Hospitals between August 2013 and December 2015. Three different groups were categorized according to final BCVA. Various preoperative, operative, and postoperative Factors were analyzed for their prognostic value for a good visual outcome and a poor visual outcome.
RESULTS: There were 74 males and 6 females with a mean age of 28.80±7.82 years. Hammering and chiseling were the most frequent source of injury occurred in 69 patients (86.25 %). Final best corrected visual acuity (BCVA) was equivalent to or more than 0.5 (good outcome) in 28 patients, between 0.1–0.4 in 20 patients and less than 0.1 (poor outcome) in 32 patients. Age, sex of patients and preoperative retinal detachment (RD) were statistically insignificant for visual outcome. Initial poor BCVA was found to be highly significant for poor final BCVA (p<0.001). Corneoscleral entry site and intraretinal FB location were found to be highly significant for poor visual outcome (p<0.001). Corneal entry site and IOFBs finally located in vitreous cavity were highly significant for good outcome (p<0.001). Presence of preoperative endophthalmitis and postoperative RD were found to be significant for poor visual outcome (p = 0.037, 0.006 respectively).
CONCLUSIONS: Many prognostic factors were recognized which aid in predicting visual outcome and identifying which patients are at highest risk for visual loss. Initial BCVA, FB entry site and location, preoperative endophthalmitis and postoperative RD were the most significant prognostic factors in predicting visual outcome.
KEYWORDS Prognostic factors; intraocular foreign body; pars plana vitrectomy