Skip to main content
Top
Published in: BMC Ophthalmology 1/2015

Open Access 01-12-2015 | Research article

23 Gauge pars plana vitrectomy for the removal of retained intraocular foreign bodies

Authors: Kemal Yuksel, Ugur Celik, Cengiz Alagoz, Huseyin Dundar, Burcu Celik, Ahmet Taylan Yazıcı

Published in: BMC Ophthalmology | Issue 1/2015

Login to get access

Abstract

Background

To evaluate the morpho-functional outcomes and safety of transconjuctival 23-gauge pars plana vitrectomy(PPV) for removal of intraocular foreign bodies (IOFBs).

Methods

A retrospective study of 36 consecutive cases (mean age; 34,2 ± 10,9 years (between 15 and 60), 27 M,9 F) of 23-G PPV for the removal of IOFBs during the period of April 2009 and December 2011 and followed 9,4 ± 6,4(2–27) months were conducted. Visual outcomes, slit lamp biomicroscopy, intraocular pressure (IOP), and posterior segment visualization by indirect ophthalmoscopy, A-B mode ultrasonography, and computed orbital tomography were performed for all cases. Main outcomes including anatomic and visual outcomes, and both intraoperative and postoperative complications were recorded.

Results

Of the 36 cases available for the study, the IOFBs (size range, 3 to 12 mm) could be removed in all eyes. Mean preoperative LogMAR BCVA was 1.44 ± 138 (range, 1.00 to 0.00) and mean postoperative LogMAR BCVA at final visit was 0,78 ± 0,98 (range, 1.00 to 0.00). (P = 0,007) Anatomic success was obtained in 97.2 % of eyes. 16 patients needed primary wound repair due to the leakage in insertion sites before the PPV, however remaining 20 cases were not. Fibrin reaction was seen in 8 (22.2 %) patients in early postoperative period, intraocular pressure elevation was detected in 12 (33.3 %) patients in which the silicone oil was used as an intravitreal tamponade, one patient with silicone oil tamponade developed band keratopathy and phthisis bulbi.

Conclusions

23-Gauge PPV is a feasible, effective approach in the surgical management of the patients with posterior segment intraocular foreign bodies.
Literature
1.
go back to reference Pieramici DJ, Mac Cumber MW, Humayun MU, Marsh MJ, de Juan Jr E. Open-globe injury. Update on types of injuries and visual results. Ophthalmology. 1996;103:1798–803.CrossRefPubMed Pieramici DJ, Mac Cumber MW, Humayun MU, Marsh MJ, de Juan Jr E. Open-globe injury. Update on types of injuries and visual results. Ophthalmology. 1996;103:1798–803.CrossRefPubMed
2.
go back to reference Agrawal R, Shah M, Mireskandari K, Yong GK. Controversies in ocular trauma classification and management: Review. Int Ophthalmol. 2013;33:435–45.CrossRefPubMed Agrawal R, Shah M, Mireskandari K, Yong GK. Controversies in ocular trauma classification and management: Review. Int Ophthalmol. 2013;33:435–45.CrossRefPubMed
3.
go back to reference Esmaeli B, Elner SG, Schork MA, Elner VM. Visual outcome and ocular survival after penetrating trauma. A clinicopathologic study. Ophthalmology. 1995;102:393–400.CrossRefPubMed Esmaeli B, Elner SG, Schork MA, Elner VM. Visual outcome and ocular survival after penetrating trauma. A clinicopathologic study. Ophthalmology. 1995;102:393–400.CrossRefPubMed
4.
go back to reference Zhang Y, Zhang M, Jiang C, Qiu HY. Intraocular foreign bodies in china: clinical characteristics, prognostic factors, and visual outcomes in 1,421 eyes. Am J Ophthalmol. 2011;152:66–73.CrossRefPubMed Zhang Y, Zhang M, Jiang C, Qiu HY. Intraocular foreign bodies in china: clinical characteristics, prognostic factors, and visual outcomes in 1,421 eyes. Am J Ophthalmol. 2011;152:66–73.CrossRefPubMed
5.
go back to reference Peyman GA, Raichand M, Goldberg MF, Brown S. Vitrectomy in the management of intraocular foreign bodies and their complications. Br J Ophthalmol. 1980;64:476–82.CrossRefPubMedPubMedCentral Peyman GA, Raichand M, Goldberg MF, Brown S. Vitrectomy in the management of intraocular foreign bodies and their complications. Br J Ophthalmol. 1980;64:476–82.CrossRefPubMedPubMedCentral
6.
go back to reference Alfaro DV, Roth D, Liggett PE. Posttraumatic endophthalmitis. Causative organisms, treatment, and prevention. Retina. 1994;14:206–11.CrossRefPubMed Alfaro DV, Roth D, Liggett PE. Posttraumatic endophthalmitis. Causative organisms, treatment, and prevention. Retina. 1994;14:206–11.CrossRefPubMed
7.
go back to reference Chaudhry IA, Shamsi FA, Al-Harthi E, Al-Theeb A, Elzaridi E, Riley FC. Incidence and visual outcome of endophthalmitis associated with intraocular foreign bodies. Graefes Arch Clin. 2008;246:181–6.CrossRef Chaudhry IA, Shamsi FA, Al-Harthi E, Al-Theeb A, Elzaridi E, Riley FC. Incidence and visual outcome of endophthalmitis associated with intraocular foreign bodies. Graefes Arch Clin. 2008;246:181–6.CrossRef
8.
go back to reference Chow DR1, Garretson BR, Kuczynski B, Williams GA, Margherio R, Cox MS, et al. External versus internal approach to the removal of metallic intraocular foreign bodies. Retina. 2000;20:364–9. Chow DR1, Garretson BR, Kuczynski B, Williams GA, Margherio R, Cox MS, et al. External versus internal approach to the removal of metallic intraocular foreign bodies. Retina. 2000;20:364–9.
9.
go back to reference Ahmadieh H, Sajjadi H, Azarmina M, Soheilian M, Baharivand N. Surgical management of intraretinal foreign bodies. Retina. 1994;14:397–403.CrossRefPubMed Ahmadieh H, Sajjadi H, Azarmina M, Soheilian M, Baharivand N. Surgical management of intraretinal foreign bodies. Retina. 1994;14:397–403.CrossRefPubMed
10.
go back to reference Bencic G, Vatavuk Z, Mandic Z. Novel approach in the treatment of intravitreal foreign body and traumatic cataract: Three case reports. Croat Med J. 2004;45:283–86.PubMed Bencic G, Vatavuk Z, Mandic Z. Novel approach in the treatment of intravitreal foreign body and traumatic cataract: Three case reports. Croat Med J. 2004;45:283–86.PubMed
11.
go back to reference Pavlovic S. Primary intraocular lens implantation during pars plana vitrectomy and intraretinal foreign body removal. Retina. 1999;19:430–6.CrossRefPubMed Pavlovic S. Primary intraocular lens implantation during pars plana vitrectomy and intraretinal foreign body removal. Retina. 1999;19:430–6.CrossRefPubMed
12.
go back to reference Lai WW, Meyers SM, Brent GF, Humayan M, Langston RHS. Management of the retinal impact site after intraocular foreign body trauma. Ophthalmology. 2000;107:811–2.CrossRefPubMed Lai WW, Meyers SM, Brent GF, Humayan M, Langston RHS. Management of the retinal impact site after intraocular foreign body trauma. Ophthalmology. 2000;107:811–2.CrossRefPubMed
13.
go back to reference Sobacı G, Mutlu FM, Bayer A, Karagu S, Yıldırım E. Deadly weapon-related open-globe injuries: outcome assessment by the ocular trauma classification system. Am J Ophthalmol. 2000;129:47–53.CrossRefPubMed Sobacı G, Mutlu FM, Bayer A, Karagu S, Yıldırım E. Deadly weapon-related open-globe injuries: outcome assessment by the ocular trauma classification system. Am J Ophthalmol. 2000;129:47–53.CrossRefPubMed
14.
go back to reference El-Asrar AM, Al-Amro SA, Khan NM, Kangave D. Visual outcome and prognostic factors after vitrectomy for posterior segment foreign bodies. Eur J Ophthalmol. 2000;10:304–11.PubMed El-Asrar AM, Al-Amro SA, Khan NM, Kangave D. Visual outcome and prognostic factors after vitrectomy for posterior segment foreign bodies. Eur J Ophthalmol. 2000;10:304–11.PubMed
15.
go back to reference Jonas JB, Knorr HLJ, Budde WM. Prognostic factors in ocular injuries caused by intraocular or retrobulbar foreign bodies. Ophthalmology. 2000;107:823–8.CrossRefPubMed Jonas JB, Knorr HLJ, Budde WM. Prognostic factors in ocular injuries caused by intraocular or retrobulbar foreign bodies. Ophthalmology. 2000;107:823–8.CrossRefPubMed
16.
go back to reference Tomic Z, Pavlovic S, Latinovic S. Surgical treatment of penetrating ocular injuries with retained intraocular foreign bodies. Eur J Ophthalmol. 1996;6:322–6.PubMed Tomic Z, Pavlovic S, Latinovic S. Surgical treatment of penetrating ocular injuries with retained intraocular foreign bodies. Eur J Ophthalmol. 1996;6:322–6.PubMed
17.
go back to reference Greven CM, Engelbrecht NE, Slusher M, Nagy SS. Ocular foreign bodies: management, prognostic factors and visual outcomes. Ophthalmology. 2000;107:608–12.CrossRefPubMed Greven CM, Engelbrecht NE, Slusher M, Nagy SS. Ocular foreign bodies: management, prognostic factors and visual outcomes. Ophthalmology. 2000;107:608–12.CrossRefPubMed
18.
go back to reference Cleary PE, Ryan SJ. Histology of wound, vitreous, and retina in experimental posterior penetrating eye injury in the rhesus monkey. Am J Ophthalmol. 1979;88:221–31.CrossRefPubMed Cleary PE, Ryan SJ. Histology of wound, vitreous, and retina in experimental posterior penetrating eye injury in the rhesus monkey. Am J Ophthalmol. 1979;88:221–31.CrossRefPubMed
19.
go back to reference Cleary PE, Ryan SJ. Vitrectomy in penetrating eye injury: results of a controlled trail of vitrectomy in an experimental posterior penetrating eye injury in the rhesus monkey. Arch Ophthalmol. 1981;99:287–92.CrossRefPubMed Cleary PE, Ryan SJ. Vitrectomy in penetrating eye injury: results of a controlled trail of vitrectomy in an experimental posterior penetrating eye injury in the rhesus monkey. Arch Ophthalmol. 1981;99:287–92.CrossRefPubMed
20.
go back to reference Mieler WF, Ellis MK, Williams DF, Han DP. Retained intraocular foreign bodies and endophthalmitis. Ophthalmology. 1990;97:1532–8.CrossRefPubMed Mieler WF, Ellis MK, Williams DF, Han DP. Retained intraocular foreign bodies and endophthalmitis. Ophthalmology. 1990;97:1532–8.CrossRefPubMed
21.
go back to reference Erakgun T, Egrilmez S. Prognostic factors in vitrectomy for posterior segment intraocular foreign bodies. J Trauma. 2008;64:1034–7.CrossRefPubMed Erakgun T, Egrilmez S. Prognostic factors in vitrectomy for posterior segment intraocular foreign bodies. J Trauma. 2008;64:1034–7.CrossRefPubMed
22.
go back to reference Choovuthayakorn J1, Hansapinyo L, Ittipunkul N, Patikulsila D, Kunavisarut P. Predictive factors and outcomes of posterior segment intraocular foreign bodies. Eye (Lond). 2011;25:1622–6.CrossRef Choovuthayakorn J1, Hansapinyo L, Ittipunkul N, Patikulsila D, Kunavisarut P. Predictive factors and outcomes of posterior segment intraocular foreign bodies. Eye (Lond). 2011;25:1622–6.CrossRef
23.
go back to reference Falavarjani KG1, Hashemi M, Modarres M, Parvaresh MM, Naseripour M, Nazari H, et al. Vitrectomy for posterior segment intraocular foreign bodies, visual and anatomical outcomes. Middle East Afr J Ophthalmol. 2013;20:244–7. Falavarjani KG1, Hashemi M, Modarres M, Parvaresh MM, Naseripour M, Nazari H, et al. Vitrectomy for posterior segment intraocular foreign bodies, visual and anatomical outcomes. Middle East Afr J Ophthalmol. 2013;20:244–7.
24.
go back to reference Chiquet C, Zech JC, Denis P, Adeleine P, Trepsat C. Intraocular foreign bodies. Factors influencing final visual outcome. Acta Ophthalmol Scand. 1999;77:321–5.CrossRefPubMed Chiquet C, Zech JC, Denis P, Adeleine P, Trepsat C. Intraocular foreign bodies. Factors influencing final visual outcome. Acta Ophthalmol Scand. 1999;77:321–5.CrossRefPubMed
25.
go back to reference Greven CM, Engelbert NE, Slusher SS, Nagy SS. Intraocular foreign bodies. Management, prognostic factors and visual outcomes. Ophthalmology. 2000;107:608–12.CrossRefPubMed Greven CM, Engelbert NE, Slusher SS, Nagy SS. Intraocular foreign bodies. Management, prognostic factors and visual outcomes. Ophthalmology. 2000;107:608–12.CrossRefPubMed
26.
go back to reference Park DH, Shin JP, Kim SY. Surgically induced astigmatism in combined phacoemulsification and vitrectomy; 23-gauge transconjunctival sutureless vitrectomy versus 20-gauge standard vitrectomy. Graefes Arch Clin Exp Ophthalmol. 2009;247:331–7.CrossRef Park DH, Shin JP, Kim SY. Surgically induced astigmatism in combined phacoemulsification and vitrectomy; 23-gauge transconjunctival sutureless vitrectomy versus 20-gauge standard vitrectomy. Graefes Arch Clin Exp Ophthalmol. 2009;247:331–7.CrossRef
27.
go back to reference Yanyali A, Horozoglu F, Macin A, et al. Corneal topographic changes after transconjunctival 23-gauge sutureless vitrectomy. Int Ophthalmol. 2011;31:277–82.CrossRefPubMed Yanyali A, Horozoglu F, Macin A, et al. Corneal topographic changes after transconjunctival 23-gauge sutureless vitrectomy. Int Ophthalmol. 2011;31:277–82.CrossRefPubMed
28.
go back to reference Kiss S, Vavvas D. 25-gauge transconjunctival sutureless pars plana vitrectomy for the removal of retained lens fragments and intraocular foreign bodies. Retina. 2008;28:1346–51.CrossRefPubMed Kiss S, Vavvas D. 25-gauge transconjunctival sutureless pars plana vitrectomy for the removal of retained lens fragments and intraocular foreign bodies. Retina. 2008;28:1346–51.CrossRefPubMed
29.
go back to reference Kunikata H, Uematsu M, Nakazawa T, Fuse N. Successful removal of large intraocular foreign body by 25gauge microincision vitrectomy surgery. J Ophthalmol. 2011;2011:940323.CrossRefPubMedPubMedCentral Kunikata H, Uematsu M, Nakazawa T, Fuse N. Successful removal of large intraocular foreign body by 25gauge microincision vitrectomy surgery. J Ophthalmol. 2011;2011:940323.CrossRefPubMedPubMedCentral
30.
go back to reference Singh R, Bhalekar S, Dogra MR, Gupta A. 23-gauge vitrectomy with intraocular foreign body removal via the limbus: an alternative approach for select cases. Indian J Ophthalmol. 2014;62:707–10.CrossRefPubMedPubMedCentral Singh R, Bhalekar S, Dogra MR, Gupta A. 23-gauge vitrectomy with intraocular foreign body removal via the limbus: an alternative approach for select cases. Indian J Ophthalmol. 2014;62:707–10.CrossRefPubMedPubMedCentral
31.
go back to reference Gaudio AR. Intraocular foreign bodies: Albert DM, Jacobiec FA, eds. Principles and Practice of Ophthalmology. Philadelphia: WB Saunders Company. 200:2514–2530 Gaudio AR. Intraocular foreign bodies: Albert DM, Jacobiec FA, eds. Principles and Practice of Ophthalmology. Philadelphia: WB Saunders Company. 200:25142530
32.
go back to reference Gopal L, Bauker AS, Deb N, Badrinath SS, Sharma T, Parikh SN, et al. Management of glass intraocular foreign bodies. Retina. 1998;18:213–20.CrossRefPubMed Gopal L, Bauker AS, Deb N, Badrinath SS, Sharma T, Parikh SN, et al. Management of glass intraocular foreign bodies. Retina. 1998;18:213–20.CrossRefPubMed
33.
go back to reference Karel I, Diblik P. Management of posterior segment foreign bodies and long-term results. Eur J Ophthalmol. 1995;5(2):113–8. PubMed PMID:7549439. Karel I, Diblik P. Management of posterior segment foreign bodies and long-term results. Eur J Ophthalmol. 1995;5(2):113–8. PubMed PMID:7549439.
34.
go back to reference Bai HQ, Yao L, Meng XX, Wang YX, et al. Visual outcome following intraocular foreign bodies: a retrospective review of 5-year clinical experience. Eur J Ophthalmol. 2011;21:98–103.CrossRefPubMed Bai HQ, Yao L, Meng XX, Wang YX, et al. Visual outcome following intraocular foreign bodies: a retrospective review of 5-year clinical experience. Eur J Ophthalmol. 2011;21:98–103.CrossRefPubMed
35.
go back to reference Maneschg OA. Resch M, Papp A, et al.:Prognostic factors and visual outcome for open globe injuries with intraocular foreign bodies. Klin Monbl Augenheilkd. 2011;228:801–7.CrossRefPubMed Maneschg OA. Resch M, Papp A, et al.:Prognostic factors and visual outcome for open globe injuries with intraocular foreign bodies. Klin Monbl Augenheilkd. 2011;228:801–7.CrossRefPubMed
36.
go back to reference Wickham L, Xing W, Bunce C, Sullivan P. Outcomes of surgery for posterior segment intraocular foreign bodies a retrospective review of 17 years of clinical experience. Graefes Arch Clin Exp Ophthalmol. 2006;244:1620–6.CrossRefPubMed Wickham L, Xing W, Bunce C, Sullivan P. Outcomes of surgery for posterior segment intraocular foreign bodies a retrospective review of 17 years of clinical experience. Graefes Arch Clin Exp Ophthalmol. 2006;244:1620–6.CrossRefPubMed
37.
go back to reference Wani VB, Al-Ajmi M, Thalib L, et al. Vitrectomy for posterior segment intraocular foreign bodies: visual results and prognostic factors. Retina. 2003;23:654–60.CrossRefPubMed Wani VB, Al-Ajmi M, Thalib L, et al. Vitrectomy for posterior segment intraocular foreign bodies: visual results and prognostic factors. Retina. 2003;23:654–60.CrossRefPubMed
Metadata
Title
23 Gauge pars plana vitrectomy for the removal of retained intraocular foreign bodies
Authors
Kemal Yuksel
Ugur Celik
Cengiz Alagoz
Huseyin Dundar
Burcu Celik
Ahmet Taylan Yazıcı
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2015
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-015-0067-2

Other articles of this Issue 1/2015

BMC Ophthalmology 1/2015 Go to the issue