New classification of ocular foreign bodies

Globe and Adnexal Trauma Terminology Survey

Importance

Ocular trauma terminology should be periodically updated to enable comprehensive capturing and monitoring of ocular trauma in clinical and research settings.

Objective

To update terminology for globe and adnexal trauma.

Design, Setting, and Participants

A 2-round modified Delphi survey was conducted from January 1 to July 31, 2021, using an expert panel, including 69 ophthalmologists identified through their membership in ophthalmology (globe and adnexal trauma) societies. Consensus was defined as at least 67% expert agreement. A steering committee developed questions after identifying gaps in the current terminology via a targeted literature review. Round 1 sought consensus on existing and newly proposed terminology, and round 2 focused on unresolved questions from round 1. Experts included ophthalmologists who had managed, on average, 52 globe or adnexal trauma cases throughout their careers and/or published a total of 5 or more globe or adnexal trauma-related peer-reviewed articles.

Main Outcomes and Measures

Expert consensus on ocular and adnexal terms.

Results

A total of 69 experts participated in and completed round 1 of the survey. All 69 participants who completed round 1 were asked to complete round 2, and 58 responses were received. Consensus was reached for 18 of 25 questions (72%) in round 1 and 4 of 7 questions (57%) in round 2. Existing Birmingham Eye Trauma Terminology system terminology achieved consensus of 84% (58 of 69 experts) in round 1 and 97% (56 of 58 experts) in round 2. Experts agreed on the need for further refinement of the definition of zones of injury (55 of 69 [80%]), as the zone affected can have a substantial effect on visual and functional outcomes. There was consensus that the mechanism of injury (52 of 69 [75%]) and status of the lacrimal canaliculi (54 of 69 [78%]), nasolacrimal ducts (48 of 69 [69%]), lens (46 of 58 [80%]), retina (42 of 58 [73%]), and central and paracentral cornea (47 of 58 [81%]) be included in the revised terminology.

Conclusions and Relevance

There was consensus (defined as at least 67% expert agreement) on continued use of the existing Birmingham Eye Trauma Terminology system definitions and that additional terms are required to update the current ocular trauma terminology.

The Demographic and Social Characteristics of Patients with Ocular Foreign Bodies in a Greek Tertiary Hospital

Purpose

Patients and Methods

Results

Conclusion

The outcomes of bimanual posterior segment intraocular foreign body removal with vitrectomy and description of two different handshake techniques: A single surgeon case series

PURPOSE

To evaluate the outcomes of bimanual intraocular foreign body (IOFB) removal with vitrectomy and describe the techniques of "active aspiration to forceps" and "forceps to forceps handshake" for IOFB removal.

METHODS

Retrospective, interventional, single surgeon case series. The patients who had an IOFB and underwent vitrectomy with bimanual IOFB removal techniques and had a minimum follow-up period of 12 months were included. The main outcome measure was the functional and anatomical results of the bimanual surgical techniques.

RESULTS

Twenty eyes were included. The mean follow-up time after surgery was 16.5±3.6 months (range 12-24 months). The baseline best corrected visual acuity (BCVA) was light perception in 8 eyes (40%), hand motions in one eye (5%), and≥1.0LogMAR in 11 eyes (55%). BCVA improved in 14 eyes (70%); was stable in 3 eyes (15%), and decreased in 3 eyes (15%).

CONCLUSIONS

Both bimanual handshake techniques were safe and effective methods in the surgical treatment of IOFBs<5mm in size. The "active aspiration to forceps handshake" technique might be a gentle technique for the removal of IOFBs that are located on the surface of or trapped within the retina.