Visual outcome following penetrating globe injuries with retained intraocular foreign bodies

Background: In our institution the occurrence of endophthalmitis related to intraocular foreign bodies has been rare. In this review we analyse the ou tcome of eyes with retained intraocular foreign bodies presenting to two vi treoretinal surgeons over nearly 7 years, Methods: Review of the records of 26 patients who presented to two surgeons in a tertiary care vitreoretinal service in Toronto between January 1989 a nd November 1995, Information documented included mechanism of injury, time from injury to definitive surgery, entry site, presence of vitreous hemorr hage, type of surgery performed, initial and final visual acuity, and devel opment of endophthalmitis. Results: All the injuries occurred in male patients, with a mean age of 36. 1 (range 15 to 55) years, Most of the injuries occurred in the workplace, a nd in most cases (17 [65.4%]) the mechanism of injury was "metal on metal." The entry site was via a perforating wound of the cornea in 16 cases (61.5 %). Almost all cases were repaired within 48 hours by means of pars plana v itrectomy. Concurrent lensectomy was required in 18 cases (69.2%) for lens damage at the time of the original injury, Vitreous hemorrhage was present in 22 cases (84.6%). One patient (3.8%) manifested clinically apparent endo phthalmitis, which responded to intravitreal antibiotic therapy. Nineteen e yes (73.1%) had a final visual acuity of 6/24 or better. Eyes with coexisti ng or subsequent retinal detachment had significantly worse vision than tho se without retinal detachment (p < 0.001), Interpretation: The incidence of endophthalmitis in our series is lower tha n that in other published series, Prompt definitive treatment was associate d with a good prognosis in most cases.