Effectiveness and prognosis of 23G vitrectomy for perforating ocular trauma caused by metallic foreign bodies / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

@#AIM: To summarize the characteristics of ocular perforation caused by metallic foreign body, evaluate the effectiveness and safety of 23G vitrectomy, and analyze the factors that affect the final vision of patients with ocular trauma score. <p>METHODS: Continuous observation and analysis from July 1, 2014 to June 1, 2016, hospitalized in our hospital caused by metallic perforating ocular trauma for 23G vitrectomy in 38 cases(38 eyes). A prospective collection of patient included age, gender, eye, place of occurance of trauma, foreign body size, wound length, foreign body position, initial visual acuity and final visual acuity, macular etc.. The ocular trauma score(OTS)system was used to assess the effectiveness and prognosis of the patients. The follow-up time was over 6mo. <p>RESULTS: There were 38 eyes in 38 patients, including 37 males and 1 females, aged 16y-56y. Ocular trauma mainly occurred in the workplace, 33 cases accounted for 87%, followed by sports venues, 3 cases accounting for 8%. Corrected visual acuity more than 0.1 in eyes with intraocular foreign bodies underwent 23G vitrectomy were 21 cases, accounting for 55%. Preoperative retinal detachment, large foreign body(more than 5.0mm), damage of lens were important factors of poor prognosis. Foreign bodies were located in the vitreous body in 23 cases, accounting for 61%, located in the retina in 15 cases, accounting for 39%. When admitted to hospital, the patients suffered from retinal detachment in 21 cases(55%), endophthalmitis in 7 cases(18%), the size of intraocular foreign bodies(IFOB)was larger than 5.0mm in 7 cases(18%), severe postoperative proliferative vitreoretinopathy(PVR)was in 6 cases(16%), epiretinal membrance of macula in 5 cases(13%). Of the same OTS scores, visual acuity in 6mo was significantly better than preoperative; no matter preoperative vision or postoperative vision in 6mo, the higher the OTS scores, the better the visual acuity. <p>CONCLUSION: The ocular perforation caused by metallic foreign body mostly occurs in young men under 40y, and the main reason is injury in the workplace. No protective measures are adopted. The main factors affecting the final visual acuity are retinal detachment, foreign body greater than 5.0mm and postoperative PVR appearance after the injury, vitrectomy time has little effect. The 23G vitrectomy is safe, reliable and effective in the treatment of ocular penetrating injuries due to metallic foreign bodies. OTS score can be used effectively in patients with ocular perforation caused by metallic foreign bodies and make reasonable and useful postoperative visual acuity prediction.