Intraocular foreign bodies. Factors influencing final visual outcome

Purpose: To identify the prognostic factors of poor visual outcome (visual acuity less than or equal to 6/240) in eyes with intraocular foreign bodies, Methods: The records of 95 consecutive patients were retrospectively reviewed for 6 years (1990-1995), All eyes underwent a primary surgical repair and foreign-body removal (electromagnet or vitrectomy), The mean follow-up period was 25 months (6-72 months). Single analysis and multiple logistic stepwise regression analysis were performed to determine predictors of poor vision. Results: Thirty patients (31.6%) showed 6/240 or worse vision at the end of their follow-up period. Three significant predictive factors had independent and combined effects on post-operative visual outcome: a corneo-scleral entry wound (odds ratio (OR)=14.5, p=0.001), largest diameter of IOFB (OR=1.21, p=0.01) and the presence of secondary retinal detachment (OR=9.48, p=0.0002), Post-operative complications included traumatic cataracts (51%), retinal detachments (28%) and phthisis bulbi (8%). Conclusion: Using multivariate analysis, corneo-scleral entry wound, largest diameter of foreign body and secondary retinal detachment were found to be predictors of poor visual outcome after intraocular foreign body removal. Our results suggest that patients with high-risk intraocular foreign body trauma should be candidates for pars plana vitrectomy rather than electromagnet procedure.