Minimal surgery achieved good visual acuity in selected patients with magnetic intravitreal foreign body and traumatic cataract

Microsurgical Vitrectomy with Pars Plana Incision for the Removal of Posterior Segment Intraocular Foreign Bodies

This study describes a pars plana incision surgical technique combined with 23 or 25-gauge vitrectomy in the management of intraocular foreign bodies (IOFBs) and to assess its anatomical and functional results. Sixteen patients with ocular trauma complicated with IOFB were enrolled in our study. The mean preoperative visual acuity was 2.01 ± 0.55 LogMAR, and the mean postoperative visual acuity at the final visit was improved to 0.91 ± 0.58 LogMAR (p < 0.001). Until the last follow-up, all IOFBs were successfully removed and anatomic success was obtained. Complications, such as endophthalmitis, silicone oil-dependent, and ocular hypotonia, were not observed. Microsurgical vitrectomy with modified pars plana incision is a safe and effective procedure in the treatment of retained IOFB, especially associated with transparent lens and posterior segment injury.

Combined Phacovitrectomy with Metallic Intraocular Foreign Body Removal through Corneal Incision Using A Novel "Magnetic Conduction" Technique

PURPOSE

To describe a "magnetic conduction" technique for the removal of metallic intraocular foreign bodies (IOFBs) in the posterior segment combined with cataract extraction and pars plana vitrectomy and to report its outcomes.

METHODS

We retrospectively analyzed the data of 42 eyes of 42 patients with posterior metallic IOFBs between April 2020 and February 2022. In all patients, cataract extraction was combined with pars plana vitrectomy. With an external magnet, the IOFBs were captured by a magnetized vitrectomy cutter, delivered to the anterior chamber, and then extracted through a corneal phacoemulsification incision.

RESULTS

All patients were men, with a mean age of 45.6 ± 10.7 years. The mean size of the IOFBs was 3.5 ± 1.7 mm (range, 1.5-8.9 mm) in their longest dimension. A final best-corrected visual acuity of 20/200 or better was noted in 24 of 42 patients (57.1%). Postoperatively, recurrent retinal detachment was seen in three eyes. There were no other intraoperative or postoperative complications.

CONCLUSION

The "magnetic conduction" technique combined with phacovitrectomy is a safe and feasible approach to removing IOFBs in the posterior segment.

Vision function of pseudophakic eyes with posterior capsular opacification under different speed and spatial frequency

PURPOSE

To investigate the characteristics of dynamic visual acuity (DVA) and contrast sensitivity (CS) in pseudophakic patients with posterior capsular opacification (PCO).

METHODS

Fifty-four eyes (36 patients) with PCO planned for laser capsulotomy were recruited. They underwent examinations of static visual acuity (SVA), DVA, CS and optical quality analysis (OQAS) before and one week after the laser treatment. Improvements in each index after laser treatment were analyzed. The visual quality of patients with good initial vision was studied separately.

RESULTS

SVA, DVA and CS all significantly increased after capsulotomy (P < 0.05). Postoperative improvements in DVA were higher than in SVA, but they decreased when the speed increased. DVA at 15 dps gained the most improvement after capsulotomy. DVA at all analyzed speeds was significantly lower than SVA (P = 0.000). There was a significant speed-dependent decrease in DVA at lower speeds compared with higher speeds. The postoperative improvements in CS decreased when the spatial frequency was increased. The CS at the lower frequencies of 3 cpd and 6 cpd was the most improved after capsulotomy. CS was much lower at high frequencies (p < 0.05). There was a significant decrease in CS at higher spatial frequencies compared with lower frequencies. DVA improvements were correlated with CS improvements at medium spatial frequencies and with objective scattering index and Strehl ratio. The CS at all frequencies significantly improved for patients with good initial vision.

CONCLUSION

PCO could impair dynamic vision function, but CS was a more sensitive indication of visual complaints in patients with slight PCO.

Visual Outcomes and Prognostic Factors of Intralenticular Foreign Bodies in a Tertiary Hospital in North China

Purpose

The aim of this study is to describe the epidemiological and visual outcomes and to identify the main prognostic factors of intralenticular foreign body (ILFB) injuries.

Methods

We performed a retrospective review of 21 patients (21 eyes) referred to Hebei Eye Hospital in North China from January 2012 to December 2017, who underwent surgical removal of ILFBs and associated ocular trauma repairs. Data regarding the patient demographics, cause of the injury, nature of the ILFB, clinical features, time interval between the injury and the ILFB removal, time interval between the presentation and the surgery, and the initial and final best-corrected visual acuities (BCVAs) were analyzed, and the main prognostic factors were identified.

Results

Male adults were most affected by ILFBs (90.5%). The mean age of the patients was 41.5 years (median: 46 years, range: 21 to 60 years). None of the patients were wearing goggles at the time of the injury. The most common ILFB cause was hammering the metal (57.1%), and most of the ILFBs were metallic (71.4%). After medical treatment, the final BCVA was improved significantly (Z = 2.49, P=0.015). There was a significant association between the ILFBs with posterior segment injuries and the final BCVA (χ² = 10.03, P=0.01). Those factors showing no statistical association with the final BCVA included the age (χ² = 0.36, P=1.0), gender (χ² = 0.52, P=1.0), nature of the ILFB (χ² = 1.11, P=0.54), entrance wound location (χ² = 2.85, P=0.25), and time interval between the injury and the ILFB removal (χ² = 1.87, P=0.23).

Conclusion

This is the first local study to explore the epidemiology of ILFB injuries and to identify the main prognostic factors. There was a significant association between the ILFBs with posterior segment injuries and the final BCVA. Improved public awareness and strengthened education regarding safety are the key approaches to reduce the incidence of eye injuries.