Clinical characteristics and trauma associated factors with poor visual outcomes in post-surgical removal of posterior segment intraocular foreign bodies in a low-resource setting, Guatemala.

Author: Roberto Jule (El Salvador)

Co-authors: José Manuel del Cid, Joaquin Barnoya, José Ceballos, Ryan Bradshaw, Juan Pablo Tovar

Purpose

To identify predictive factors for visual outcomes in post-surgical removal of posterior segment intraocular foreign bodies.

Setting/Venue

National Unit of Ophthalmology, Guatemala City, Guatemala

Methods

Retrospective chart review of 22 eyes were included. Patients underwent surgical removal of intraocular between January 2018 to April 2020 foreign body from at National Unit of Ophthalmology, Guatemala City. Patients with known history of previous ocular injury, optic disc anomalies, signs of any previous retinopathy were excluded. Clinical characteristics included visual acuity , age, sex, and time from trauma to treatment. In addition, trauma associated variables were size of intraocular foreign body (IOFB), entry site, lesions in anterior and posterior segments. We then retrospectively used the ocular trauma score (OTS) as a predictor of visual outcome. Poor visual outcome was defined as best corrected visual acuity less than 20/200 after surgical removal. Analyses were done using SPSS.

Results

Mean (SD) age at presentation was 31.7 (14.09) years old and most were male (95%). Mean time to surgery since trauma was 12.21 hours (8.56 SD) and mean follow-up was 21 (2.2) weeks after surgery. Nearly half of injuries (41%) occurred during unprotected work-related activities (metal was the most common IOFB). Most of eyes had a corneoscleral injure as entry site with formation of traumatic cataract and during the first evaluation, Light Perception visual acuity was documented in more than half (57%) the eyes studied. Larger size IOFB bodies were associated with poor prognosis as with low visual acuity on admission. Predictions of visual outcomes using the OTS correlate with statistical significance the visual outcome on post-surgical removed posterior segment IOFB. Larger size IOFB bodies were associated with poor prognosis as with low visual acuity on admission.

Conlusions

According to our findings, the OTS could be a useful tool to predict poor outcomes after IOFB trauma in a low-resource setting like Guatemala. Corneoscleral site of entry, large IOFB and retinal tears were all associated with poor outcomes. The OTS should be implemented upon admission of all eye trauma patients in order to predict poor outcomes.

Financial Disclosure

NONE