Risk factors for endophthalmitis and retinal detachment with retained intraocular foreign bodies.

Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Journal of Ophthalmology (Impact Factor: 1.37). 01/2012; 2012:758526. DOI: 10.1155/2012/758526
Source: PubMed

ABSTRACT Purpose. To analyze risk factors for endophthalmitis and retinal detachment (RD) in patients with retained intraocular foreign bodies (IOFBs). Design. A retrospective, interventional, consecutive case series. Participants. All patients treated at Bascom Palmer Eye Institute for traumatic IOFBs between 1999 and 2008. Methods. Analysis of visual outcome, mechanism of injury, management, and postoperative course. Results. 108 eyes with IOFBs were identified. Endophthalmitis occurred in 7 eyes (6.4%) at presentation, and risk was higher with vegetable matter exposure (P = 0.003). All eyes with posterior segment IOFBs received intravitreal antibiotics and there were no cases of endophthalmitis after initial management. RD was identified in 6 of 108 eyes (5.5%) at presentation. Risk factors were entry more than 5 mm behind the limbus (P < 0.001) and posterior segment IOFB (P = 0.028). Postoperative RD occurred in 11 of 102 eyes (10.7%). Risk factors for postoperative RD were preoperative endophthalmitis (P = 0.001), posterior segment IOFB (P = 0.008), and retinal impact sites (P = 0.028). Conclusions. Risk factors for endophthalmitis included vegetable matter exposure and delay to initial management. Risk factors for RD were posterior entry site, posterior segment IOFB, endophthalmitis, and retinal impact sites. No eyes developed endophthalmitis after presentation.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Computed tomography (CT) is widely used in the initial evaluation of patients with craniofacial trauma. Due to anatomical proximity, craniofacial trauma often involves concomitant injury to the eye and orbit. These injuries may have devastating consequences to vision, ocular motility, and cosmesis. CT imaging provides a rapid and detailed evaluation of bony structures and soft tissues of the orbit, is sensitive in detection of orbital foreign bodies, and often guides clinical and surgical management decisions in orbital trauma. For this reason, radiologists should be prepared to rapidly recognize common orbital fracture patterns, accurately describe soft tissue injuries of the orbit, detect and localize retained foreign bodies within the globe and orbit, and recognize abnormalities of the contents and integrity of the globe. In this review, we present a systematic approach to assist radiologists in the rapid evaluation of orbital trauma using the "BALPINE" mnemonic-bones, anterior chamber, lens, posterior globe structures, intraconal orbit, neurovascular structures, and extraocular muscles/extraconal orbit. Using this approach, we describe common traumatic findings within each of these spaces, and present common postsurgical appearances that can mimic findings of acute trauma.
    Emergency Radiology 04/2014;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Intraocular foreign bodies (IOFBs) can complicate globe trauma and are associated with a high incidence of severe vision loss. Occult IOFBs present a particular challenge as they are not diagnosed promptly and tend to present with advanced complications, including endophthalmitis and retinal detachment. In this report, we present three cases of occult nonmetallic IOFBs presenting as fulminant uveitis, and we also review the literature.
    Clinical ophthalmology (Auckland, N.Z.) 01/2013; 7:1747-51.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the evolution of the best-corrected visual acuity (BCVA), to determine the prognostic factors, and to analyze the efficiency of the surgical procedures in the cases of ocular injuries caused by a metallic intraocular foreign body retained in the posterior segment as a result of hammering. A retrospective review of 64 consecutive patients was conducted at the Cantonal Hospital St Gallen over a 15-year period. The pre-, intra-, and postoperative clinical parameters were assessed. The statistics were performed using Fisher's exact test and a multiple correspondence analysis. The mean initial BCVA was 20/138 (standard deviation, 20/112). The mean ocular trauma score was 3.03 (standard deviation, 0.83). In all cases, the removal of the intraocular foreign body was performed within 24 hours after the injury. In 45 patients (70.3%), further operations were performed during the mean follow-up of 54.4 months (standard deviation, 22.7 months). The mean final BCVA was 20/39 (standard deviation, 20/55). In 53 patients (82.8%), the final BCVA was 20/40 or more. In 8 patients (12.5%), the final BCVA was 20/200 or less because of a direct macular lesion caused by the intraocular foreign body (P < 0.001). Thanks to the improvement in the surgical procedures, the ocular injuries with a metallic intraocular foreign body in the posterior segment as a result of hammering have a good visual outcome unless the macula is involved.
    Retina (Philadelphia, Pa.) 12/2013; · 2.93 Impact Factor

Full-text (2 Sources)

Available from
Jun 4, 2014

Similar Publications