Global, regional, and national burdens of intraocular foreign bodies in children and adolescents from 1990 to 2019: a trend analysis.

BACKGROUND: This study aimed to evaluate trends in global, regional, and national burdens of intraocular foreign bodies among children and adolescents (aged 0 - 19 years) between 1990 and 2019 according to age, sex, and socio-demographic index. METHODS: This study obtained data from the Global Burden of Disease Study 2019 and evaluated the number of cases, rates per 100,000 persons, and average annual percentage changes among children and adolescents. The annual percentage changes in the incidence and years lived with disability rates across various age groups were investigated using joinpoint software. RESULTS: For intraocular foreign bodies in children and adolescents, the incidence and year lived with disability rates decreased in all age groups between 1990 and 2019. However, the number of incident cases and years lived with disability increased from 1091.94 [95% uncertainty interval (UI), 610.91-1839.52] and 89,245 (95% UI, 6.65-18.67) in 1990 to 1134.85 (95% UI, 665.01-1867.50) and 92,108 (95% UI, 32,052-192,153) in 2019, respectively. Age was positively correlated with the number of cases, incidence, and years lived with disability rates. However, there were significant decreases in both the incidence and years lived with disability rates among children and adolescents, especially in the 15-18 years age group, males, and most high-income regions. Notably, the incidence and years lived with disability rates were significantly decreased in middle and high-middle socio-demographic index regions but were increased in low and low-middle socio-demographic index regions. CONCLUSIONS: Despite the remarkable progress between 1990 and 2019 in reducing the global burden of intraocular foreign bodies, there has been an increase in the number of cases, with substantial disparity across age groups, sexes, regions, and countries. Our results could inform more effective strategies for reducing the burden among children and adolescents.

Trends and Disparities in the Incidence of Intraocular Foreign Bodies 1990-2019: A Global Analysis.

Objectives: This study aims to provide trends and disparities in the incidence of intraocular foreign bodies (IOFBs) from 1990 to 2019 in 204 countries by region, country, socio-demographic index (SDI), age, and sex. Methods: The global, regional and national number of incident cases as well as age-standardized incidence rate (ASIR) of IOFBs were attained from the Global Burden of Disease Study 2019 (GBD 2019). To estimate the trend of ASIR of IOFBs, the estimated annual percentage change (EAPC) was calculated from 1990 to 2019. Results: Globally, although ASIR of IOFBs decreased with an EAPC of -0.93% [95% uncertainty interval (UI) -1.1 to -0.76] from 1990 to 2019, ASIR of IOFBs increased from 2008 to 2019. From 35.79 million (95% UI 23.62-50.89) in 1990 to 46.63 million (95% UI 32.45-64.45) in 2019, the number of IOFB incident cases worldwide increased by 30.29% (95% UI 19.63-43.55). The incidence of IOFBs varied by region and country, and it was closely related to socio-economic development. Furthermore, while ASIR of IOFBs was high in the young population aged 15-49 years, we observed a significant increase in the number of IOFB incident cases in older adults when compared to other age groups. In terms of sex, males accounted for the vast majority of IOFB incident cases. Conclusions: The global ASIR of IOFBs is on the rise, with an increase in incident cases, designating IOFBs as a global health challenge. The incidence of IOFBs cases is directly related to geographic location, socio-economic status, age, sex, and other factors. Our findings could be useful for the control and prevention of IOFBs.

Clinical characteristics and prognostic factors for visual outcome in 669 patients with intraocular foreign bodies.

AIM: To describe the clinical characteristics and analyze prognostic factors that influence visual outcome in 669 patients with intraocular foreign bodies (IOFBs). METHODS: Medical records of 669 patients with IOFBs from West China Hospital were reviewed. Best corrected visual acuity (BCVA) values were recorded using standard Snellen acuity chart and were converted to logarithm of the minimum angle of resolution (logMAR) scale for statistical analysis. The visual outcome was defined by the final BCVA (excellent visual outcome: final BCVA of 20/40 or better; poor visual outcome: final BCVA less than 20/200). Statistical analysis of collected data was performed using IBM SPSS Statistics version 23. A 2-tailed P value of less than 0.05 was considered statistically significant throughout the study. RESULTS: The average age ranged from 1 to 79 years old (mean age, 34.8±12.7 SD) and the majority of patients were men (626, 93.6%). The major cause of ocular injury was hammering (383, 57.2%). Almost all the patients (97.8%) underwent surgeries (97.8%) and the average time interval between injury and surgery was 26.4±322.3d (0-7300), while 327 patients received surgeries within 24h (48.9%) and 590 patients received surgeries within seven days (88.2%) after IOFBs injury. The poor BCVA was associated with older age (P=0.013), larger IOFBs size (P<0.001), presence of complications (P<0.001) and worse presenting BCVA (P<0.001). On the contrary, younger age (P=0.005), smaller IOFBs size (P<0.001), absence of complications (P<0.001) and better presenting BCVA (P<0.001) were considered to relate to excellent BCVA. CONCLUSION: Multiple prognostic factors may influence the final visual outcome, including age, size of IOFBs, complications and presenting BCVA. Meanwhile, further education and promotion on eye protection should be taken for the improvement on self-protection and self-health awareness.

Epidemiology, Clinical Characteristics, and Visual Outcomes of Patients with Intraocular Foreign Bodies in Southwest China: A 10-Year Review.

INTRODUCTION: Intraocular foreign bodies (IOFBs) are a serious subset of open-globe injury that can result in visual loss. This study analyzed the epidemiology, clinical characteristics, and visual outcomes of patients with IOFBs in Southwest China. METHODS: This retrospective study comprised 1,176 patients with the primary diagnosis of IOFBs who resided in Sichuan Province over a 10-year period. All data were collected from medical records and analyzed statistically. RESULTS: The annual incidence for IOFBs was 0.14 per 100,000 (95% confidence interval 0.12-0.16 per 100,000) people in Southwest China. In that period, IOFBs accounted for 22.3% of all open-globe injuries. Working-age male patients accounted for 79.1% of all IOFBs patients and there had significant differences in age distributions between genders (p < 0.001). Metallic IOFBs were the most common (74.6%) IOFB, but there were significant differences in the materials of IOFBs between adults and children of different age-groups (p < 0.001). At discharge, 277 (23.6%) patients had increased visual acuity (VA) and 95 (8.0%) had no light perception. Initial VA <20/200 (odds ratio [OR], 5.5; p < 0.001), increasing wound size (OR, 1.3; p = 0.004), IOFBs in the posterior segment (OR, 2.6; p = 0.002) and existing complications (traumatic cataract, endophthalmitis, retinal detachment, or retinal break) were independent risk factors for final VA <20/200. CONCLUSION: The incidence of IOFBs in Southwest China differed from global statistics. Adults and children had different clinical characteristics. Thus, their prevention strategies should be different.

Surgical outcomes of the removal of posterior segment metallic intraocular foreign bodies.

BACKGROUND: Posterior segment metallic intraocular foreign bodies (IOFBs) are a leading cause of visual morbidity and blindness, especially among young and middle-aged working populations. Here, we aimed to evaluate the surgical outcomes of the removal of such IOFBs that result from injuries. METHODS: In this retrospective study, 39 patients injured by metallic posterior segment IOFBs and who underwent primary repair procedures, vitrectomies, and IOFBs removal with or without procedures for traumatic cataract removal, scleral buckling and intraoperative tamponade application from January, 2008 to January, 2019. We analyzed the preoperative, intraoperative and postoperative related factors that affect the final visual outcomes. RESULTS: The mean age of the 39 patients was 40.51 ± 12.48 years with the male being predominent (100%).The mean preoperative vision measured 1.50 [Snellen Equivalent (SE), 20/645] ± 1.12 logMAR with the mean final vision measuring 0.93 (SE, 20/172) ± 1.09 logMAR. The related factors that were determined to affect the final visual outcomes included preoperative vision (P = 0.025), IOFB-related macula injuries (P = 0.001) and the development of postoperative complications (P = 0.005) especially retinal detachment (P = 0.002) with the mean final vision measuring 2.12 (SE, counting finger to hand motion) ±1.23 logMAR. Concerning the preoperative signs, the patients with preoperative endophthalmitis also obtained poor mean final vision measuring 1.30 (SE,20/400) ± 1.40 logMAR. CONCLUSION: IOFB-related macula injuries and postoperative retinal detachment were important related factors of poor final visual prognoses in cases involving posterior segment metallic IOFBs. Removing IOFB as early as possible may prevent preoperative endophthalmitis which could lead poor final visions even without significance.

Multimodal imaging features of intraocular foreign bodies.

Objective: To determine the imaging approach for evaluating intraocular foreign bodies (IOFBs) by comparing the ability of different modalities [plain film x-ray, computed tomography (CT), magnetic resonsance imaging (MRI), convetional ultrasound, and ultrasound biomicroscopy] to detect and characterize IOFBs.Methods & Design: Systematic review of the literature.Results: CT is the most practical first step for evaluating patients with suspected IOFBs because it can detect a wide range of IOFB types at small limitis of detection. MRI and ultrasound are best reserved as adjunctive tests in most cases although these tests may provide important insights especially with wood, plastic, and glass IOFBs. Imaging characteristics of metal, wood, glass, plastic, stone, concrete, and graphite IOFBs are reviewed.Conclusion: Understanding the limits of detection for each IOFB type and imaging modality as well as the characteristic features of different IOFBs is of paramount importance to optimizing the management of ocular trauma patients.

Scleral buckling combined with 23G vitrectomy in treatment of intraocular foreign body with retinal detachment / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the clinical effect of scleral buckling surgery combined with 23G vitrectomy in treatment of intraocular foreign body with retinal detachment.<p>METHODS: Totally 72 cases of patients with intraocular foreign bodies and retinal detachment admitted from January 2014 to January 2018 were selected and divided into the control group(36 cases)and the observation group(36 cases)by random number table method. The patients in the control group were treated with 23G vitrectomy surgery while patients in the observation group were treated with scleral buckling surgery on the basis of the treatment in the control group. The changes of intraocular pressure(IOP)and visual acuity, successful reset, recurrence and complications were observed before operation and 3mo after silicone oil was removed.<p>RESULTS: There was no difference in IOP and BCVA between the two groups before operation(<i>P</i>>0.05). Three months after silicone oil was removed, IOP and BCVA in two groups were significantly improved compared with those before operation(<i>P</i><0.05). There was no difference between the two groups(<i>P</i>>0.05). The success rates of one-time anatomical reduction in the observation group and the control group were respectively 97% and 81%(<i>P</i><0.05). The recurrence rates of the observation group and the control group were respectively 6% and 25%(<i>P</i><0.05). The incidence of complications was 22% in the observation group and 31% in the control group(<i>P</i>>0.05).<p>CONCLUSION: The treatment of scleral buckling combined with 23G vitrectomy in the treatment of intraocular foreign body with retinal detachment can significantly improve the IOP and visual acuity of patients, improve the success rate of reduction, reduce recurrence, and have high safety.

New Innovative Approaches for Difficult Retained Intraocular Foreign Bodies.

PURPOSE: To describe innovative ways of removal of complicated difficult large retained intraocular foreign bodies (RIOFBs). SETTINGS: Both cases were treated at Disha Eye Hospitals, Kolkata, a tertiary eye hospital in eastern India. METHODS: Innovative approaches were taken to remove 2 difficult RIOFBs. In the first case, a large RIOFB was just beyond the posterior exit wound, trapped in the sclera. A 23-G MVR blade was used to create multiple radial releasing scleral nicks and bimanually moving the RIOFB into the vitreous cavity using a bent-tip 24G needle and magnet, and the RIOFB was removed through the limbal section. In the second case, a 21-mm long thick nail was deeply embedded in the superior sclera with partial localised retinal detachment with its bulbous end just behind the clear lens. A lasso technique was used to remove the RIOFB without lens touch. RESULTS: In the first case, the patient finally achieved logMAR 0.2 vision after silicone oil removal and glued scleral fixation of the intraocular lens. In the second case, the patient finally achieved logMAR 0.3 vision after silicone oil removal and phacoemulsification with intraocular lens implantation. CONCLUSION: Each case of RIOFB is unique and challenging. Here, innovative techniques are helpful to rescue these difficult RIOFB situations, which can result in excellent outcomes.

Minimally Invasive Surgery for the Removal of Posterior Intraocular Foreign Bodies.

This is a prospective clinical assay that included six patients who were diagnosed with penetrating corneal injury, traumatic cataract, and posterior segment intraocular foreign body (IOFB). Following anterior segment repair and extraction of traumatic cataract by clear cornea phacoemulsification, a standard 25-gauge transconjunctival pars plana vitrectomy was performed to find and release the IOFB. With active suction using a 25-gauge silicone tipped cannula, the foreign body was retrieved and safely placed in the anterior chamber. After stabilization of the anterior chamber with viscoelastic injection, IOFB extraction through the main phaco incision was easily performed, followed by placement of an intraocular lens. Of the six patients, 66.6% showed a significant improvement of visual acuity. No complications associated directly with the surgical procedure occurred. Our surgical technique is a safe alternative for handling and removing a posterior IOFB. There was no need for a scleral incision.

Clinical Assessment of 20G and 23G Vitrectomy for Treatment of Posterior Segment Intraocular Foreign Bodies / 中山大学学报(医学科学版)

[Objective] To analyze the clinical curative effect of 20G and 23G vitrectomy for posterior segment intraocular foreign bodies,to explore the differences of their efficacy and safety.[Methods] This was a retrospective case study.Select 71 patients (71 eyes) who suffered from posterior segment intraocular foreign bodies and underwent different ways of vitrectomy,according to the way of vitrectomy,the patients were enrolled into 20G vitrectomy group (20G group,37 patients,37 eyes) and 23G vitrectomy group (23G group,34 patients,34 eyes).All patients were given wound suture,and patients complicated traumatic cataract should underwent cataract surgery;then were given 20G/23G vitrectomy and extraction of intraction foreign bodies,and (or) be given retinal laser photocoagulation,cryocoagulation,and endotamponade during the procedure.Extraction of intraction foreign bodies and the location of retinal,surgical time,postoperative inflammation and stimulus syndrome,length of hospital stay,the best corrected acuity (BCVA) and other complications after surgery were registered.Minimum follow-up was 6 months.[Results] The rate of extraction of intraction foreign bodies and early retinal reattachment rate were 100％ of the two groups.Comparing the complications after surgery between the two groups,the differences had no statistical significance (all P ＞ 0.05) except the incidence of postoperative ocular hypotenison.The significant difference was found in the comparison of surgical time,average hospitalizcd days,postoperative inflammation score and stimulus syndrome between the two groups,and there were significant differences when the vision distribution before and after surgery in two groups were self-compared (P ＜ 0.05).At lastest follow up,the differences had no statistical significance when comparing the cases of unplanned surgical reoperation,the location of retinal and the vision distribution between the two groups (P ＞ 0.05).[Conclusion] 20G and 23G vitrectomy are both safely and effectively performed in patients with posterior segment intraocular foreign bodies,the efficacy and safety of them are comparable.There is higher incidence of postoperative ocular hypotension in 23G group,and it has an ascendant than 20G group in shorter surgical time and length of hospital stay,lighter postoperative inflamnation and stimulus syndrome.

Clinical observation of early vitrectomy for open globe injuries with intraocular foreign bodies / 局解手术学杂志

Objective To evaluate the clinical effect of vitrectomy for open globe injuries with intraocular foreign bodies in 48 hours after injury.Methods Retrospective analysis was used to evaluate the patients with open globe injuries (OGIs) accompanied by intraocular foreign bodies (IOFB) who underwent vitrectomy of pars plana vitrectomy (PPV) within 48 hours during the period from January 1,2009 to March 1,2015 in our hospital.Results Among the 56 eyes,16 eyes with intraocular foreign bodies occurred endophthalmitis,while the other 40 eyes did not;the intraocular foreign bodies removal rate was 100％.Among all the patient eyes,52 eyes were saved after surgery,while 4 eyes failed.The pars plana vitrectomy operation ratio of the intraocular foreign bodies patients with endophthalmitis and operated within 24 to 48 hours was 2.09 times than that within 24 hours.There was no significant difference in terms of eye preservation,one time of retinal reposition and abnormal intraocular pressure no matter the PPV surgery was conducted within 24 hours or 24 to 48 hours after injury.Conclusion Early vitrectomy is a safe and effective method for the treatment of open globe injuries with intraocular foreign bodies.

Free Migration of Intraocular Glass in Aphakia after Glaucoma Surgery.

PURPOSE: To describe a case of free migration of intraocular glass in aphakia after glaucoma surgery. METHODS: We report the case of a 27-year-old man with a history of perforating injury to the right eye 10 years previously and glaucoma surgery 1 year previously presenting with 1 month of pain and frequent floaters in front of the right eye. On examination, the glass fragment was seen to lie free in the anterior chamber or migrate backwards through the pupil, remaining mobile on the inferior retinal surface when the patient was prone or supine, respectively. RESULTS: The fragment was surgically removed. CONCLUSION: Late migration of glass intraocular foreign bodies is a rare clinical entity, and the exact mechanism causing the migration of intraocular glass remains controversial. Early intervention must be weighed against the hazards of removal and the necessity of close follow-up.

Clinical study on the incidence of vancomycin intraocular injection in treatment with suppurative endophthalmitis / 国际眼科杂志(Guoji Yanke Zazhi)

? AlM: To estimate the clinical significance of the microculture of humor and vitreous and vancomycin intraocular injection in treatment of suppurative endophthalmitis associated with intraocular foreign bodies. ?METHODS: Totally 65 patients with penetrating eye trauma and retained intraocular foreign bodies in emergency operation and intraocular injection from January 2012 to September 2014 were regarded as the study group, another 62 patients with penetrating eye trauma and retained intraocular foreign bodies in emergency operation without intraocular injection before August 2011 were regarded as the control group. Aqueous humor and vitreous humor were taken from each patient of the study group and the control group for bacteria and fungus cultivation. The study group was treated with 1mg vancomycin intraocular injection after operation, while the control group was not. ?RESULTS: The incidence of endophthalmitis in the control group was 16% ( 10 cases ) , while in the study group was 3% ( 2 cases ) , with significant difference between two groups (x2 =6. 32, P0. 05). The positive rate of vitreous humor germiculture in study group was 14% (9 cases), and the incidence of endophthalmitis was 3%. The positive rate of vitreous humor germiculture in control group was 11% (7 cases) and the incidence of endophthalmitis was 16%, with significant differences between two groups (P<0. 05).?CONCLUSlON: lntraocular foreign bodies treated with emergency operation and vancomycin intraocular injections can decrease the incidence of suppurative endophthalmitis and have a good vision prognosis for the second stage of operation.

Application of Prussian blue staining in the diagnosis of ocular siderosis.

AIM: To explore the value of Prussian blue staining in the diagnosis of ocular siderosis. METHODS: Between January 2012 and January 2013, the Prussian blue stain used in anterior lens capsule and vitreous liquid after centrifugation from patients with definitive diagnosis and suspicious diagnosed of ocular siderosis. At the same time, give a negative control. RESULTS: Anterior lens capsule membrane and liquid of vitreous cavity from patients with definitive diagnosis and suspicious diagnosed of ocular siderosis revealed ferric ions that stained positively with Prussian blue. In the control group, there is no positive reaction. CONCLUSION: Prussian blue staining in the diagnosis of ocular siderosis has a very significant worth, suspected cases can be definitive diagnosed.

Retrospective analysis of clinical effects of intraocular foreign bodies in 46 cases / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To retrospectively analyze the effect of different surgical treatment on intraocular foreign bodies, according to different types and position. METHODS: Clinical data of 46 cases diagnosed with intraocular foreign bodies from June 2010 to April 2013 were retrospectively analyzed. RESULTS:Intraocular foreign bodies in anterior segment could be removed or magnetically attracted directly, intraocular foreign bodies in posterior segment could be attracted if there was accurate location. Vitrectomis was more favorable for the non magnetic or intraocular foreign bodies in posterior segment. In 46 cases, all intraocular foreign bodies ( 100%) in posterior segment were removed successfully. Among them the functional cure in 33 cases ( 72%) , the anatomical cure in 12 cases ( 26%) , discharged in 1 case (2%). CONCLUSION:The aim of operation is to reconstruct of eyeball structure preserve and restore visual function. We should find more appropriate mode of operation and timing of surgery according to the foreign bodies'different types and injury of eyeball, reduce complications, preservation eyeball and improve visual function.

Localization of intraocular foreign bodies by the combination of CT ocular axial scan and meridian plane reconstruction / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore a new compute tomography (CT) for the localization of intraocular foreign bodies (IOFBs).METHODS: After CT ocular horizontal and ocular axial scan,the foreign bodies on the eyeball wall or retinal surface in 26eyes were localized by means of the combination of CT ocular axial scan and meridian plane reconstruction (new method),ocular horizontal scan and ocular axial scan (conventional method Ⅰ) as well as ocular horizontal scan right angle coordination (conventional method Ⅱ) separately. According to the criteria of indirect ophthalmoscope localization and direct observation during operation, the relative accuracies of corresponding points of the foreign bodies on sclera surface along meridian and latitude were measured.RESULTS: In the 26 cases, the mean relative accuracies of corresponding points of foreign bodies on sclera surface along meridian and latitude were 1.53mm、1.64mm (new method), 1.37mm、1.64mm (conventional method Ⅰ) and 2.02mm、2.55mm (conventional method Ⅱ) respectively.There was no statistical difference between the new method and the conventional method Ⅰ, whereas there was statistical difference between the new methods and the conventional method Ⅱ (along meridian: P＜0.05; along latitude:P＜0.01).CONCLUSION: Compared with the conventional methods,the new method is simpler, more visible and more potential in the clinic.

Analysis of Bacterial Culture of Aqueous Vitreous in Eorly Stage of Intraocular Foreign Bodies / 中华医院感染学杂志

OBJECTIVE To analyse the bacterial culture of aqueous vitreous as well as their sensitivity to antibiotics in intraocular foreign bodies(IOFB).METHODS Bacterial culture of aqueous vitreous as well as their sensitivity to antibiotics were taken at 32 cases(32 eyes) of IOFBs with in 24 hours.And the results were analyzed.RESULTS 21 cases with bacterial culture of aqueous vitreous were found to be positive with bacterial infection.Staphylococcus epidermidis was the most frequently bacteria and identified in 15 cases,which accounted for 71.4% of these 21 cases.All the identified bacteria were sensitive to Ofloxacin,Ciprofloxacin and Cefoperazone,and partly sensitive to Gentamycin and Tobramycin.All of them were resistant to Chlororamphenicol and Rifapine.The occurrence of positive bacterial identification of unmetal foreign bodies were significantly higher than that of metal foreign bodies(?2=4.631,P=0.029).There was no significomt difference between.The location of penetrating eye trauma or lens rupture in the bacterial positive rate identification(?2=2.398,P=0.122;?2=0.327,P=0.568).CONCLUSIONS In patients with IOFB,the major bacteria entering into the eye was Staphylococcus epidermidis.As for prophylactic antibiotics,Quinolones and Cefoperazone can be used as the first line antibiotics.

The Study of Prognostic Factors after Vitrectomy for Posterior Segment Metallic Foreign Bodies

PURPOSE: To evaluate the clinical results and prognostic factors that predict final visual outcome in eye with posterior segment metallic foreign body(FB) managed by primary pars plana vitrectomy. METHODS: Twenty-nine patients with posterior segment FBs managed by pars plana vitrectomy were reviewed retrospectively. To determine prognostic factors for visual outcomes, variables including ocular findings at presentation, initial visual acuity(VA), location, size and weight of FBs, site of entrance, location of intraretinal lesion, mechanisms of injury and FB removal time were compared with final visual acuity. RESULTS: After a mean follow up of 19.2 months, 15 eyes(52%) achieved VA of 20/40 or better and 5 eyes(17%) showed decreased VA compared to the initial VA. Prognostic factors for the final VA of 20/40 or better included the weight of FBs less than 20 mg, negative findings of retinal detachment and endophthalmitis. Prognostic factors for the final VA of 20/200 or less included the size of FBs more than 4mm, the weight of FBs more than 20 mg, intraretinal FBs, nonhammering as the mechanism of injury. CONCLUSIONS: The predictors of the final VA were the size, the weight and the location of FBs, mechanisms of injury, preoperative negative findings of retinal detachment and endophthalmitis. These factors will be helpful for planning surgery and predicting the prognosis.