| Ocular trauma is the leading cause of blindness in teenage and young adultmales.Penetrating injuries involving retained IOFBs represent a significantsubset of ocular injuries. Injuries involving IOFBs often occur undercircumstances in which the injury may have been prevented with the use of eyeprotection. However, none in this series reported wearing eye protection at thetime of injury.IOFBs retaining improve the probability of the intraocularinfection,sympathetic ophthalmia and other severe complications.AndPenetrating injuries involving retained IOFBs has severe outcome to visualacuity,the incidence of this disease is high,so in the management of IOFBs,theprimary goals of the patient and physician are to restore the ocular integrity andobtain a good visual outcome.Secondary goals include minimizingintraoperative and postoperative complications and rehabilitating the patient ina timely manner.In this series,98 cases(from Jan,1999 to Oct,2004) were treated with parsplana vitrectomy(PPV). The first step:A scleral tunnel incision,which wasshaped in a straight line or an arc one with the flange facing the limbus,wasperformed in the upper-right quadrant.The incision was 6 millimeter in lengthand 0.5～2mm from the limbus. The second step: The routine incision of parsplana vitrectomy was done. Then the vitrectomy was finished and theopaque,proliferated tissue,and the blood clot were cleared away.The IOFBs inthe vitreous cavity can be extracted with a conducing magnetic stick(formagnetic ones) or IOFBs claw forceps(for nonmagnetic ones).The pars planaincision should be enlarged,if the minimum diameter of the IOFBs was 1mm orlarger.According to the size of the IOFBs and neovascular and retinainjury,scleral buckling,photocoagulation and retinoctomy.The third step:Cutthrough the scleral tunnel incision and enlarged it till its inside entrance waslarge than the outside one. In accordance with postoperative retina, 61 caseswere filled with BSS,27cases with C3F8,10 cases with silicon oil,and 21 caseswith additional scleral buckling. 38 cases with traumatic cataract were treatedwith lensectomy,3 have retained anterior capsule,IOLs implantation were at thetime of vitrectomy or later. After the operations,antibiotics andglucocorticosteroid were used.The cases were divided into 3 groups separatedlyby endophthalmitis, traction retinal detachment(TRD)and non-endophthalmitisand non-TRD as complications. X2test was used for numberable data,and P>0.05,no significant difference statistically;P<0.05,significant difference; P<0.01,highly significant difference. Of the 98 eyes identified with an IOFB,93 underwent surgical removal ofthe IOFB successfully.The achievement ratio was 94.90%.In 2 eyes,the foreignbody were considered insert and had excellent visual acuity(≥0.05),so were notremoved. Two eyes had too many foreign bodies,so the foreign bodies wereremoved completely in the second time.The severity of ocular trauma and finalvisual acuity rehabilitation: of 98 cases,39 cases(39/98,39.80%) have fairlygood initial visual acuity(≥0.01),howerer,69 cases(69/98,70.41%) have fairlygood final visual acuity(≥0.01),the best was 0.8.There was a tendency for IOFBwith a more severe complication to be associated with a worse visual acuity... |
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