Walkow T., Klemen U. M.

Augenklinik im AÖK St. Pölten, Österreich

Background: The aim of the present study was to show the current stand of the management of intraocular foreign bodies and to demonstrate operative techniques with typical examples.
Patients and Methods: Between March and September 2000 all patients with an intraocular foreign body who were operated in our department were enrolled prospectively for this study. There were overall 15 patients, 14 of them were men (93,3%). Mean age of all patients was 36 years (range, 19- 72 years). Most of the foreign bodies were of metallic origin (73%). In four eyes the foreign body was located in the anterior segment, in 11 eyes in the posterior segment. In 10 of 11 eyes with a posterior located foreign body a pars-plana-vitrectomy was used as the primary treatment method. In six eyes the lens had to be removed, in four of these eyes a posterior chamber intraocular lens was implanted.
Results: In all eyes the foreign bodies were removed during the first 24 hours. In none eye developed an endophthalmitis postoperatively. In none of the patients an enucleation of the injured eye was necessary. Mean visual acuity preoperatively was 0.18 (Log MAR) (range, positive light perception - 1.0). Mean visual acuity postoperatively was 0.71 (LogMAR) (range, 0.08 - 1.0). In two eyes a bleeding occurred during the removal of the foreign body intraoperatively; both could be stopped without problems. Postoperatively in two eyes an epiretinal gliosis developed, which made a second intervention necessary. In one eye after a retinal detachment developed four weeks postoperatively. In none of the primarily vitrectomized eyes a retinal detachment developed.
Discussion: Removal of a foreign intraocular body should be done during the first 24 hours. When the foreign body is located in the posterior segment, pars-plana-vitrectomy is the method of choice.

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