Br J Ophthalmol 1998;82:801-806 ( July )
Visual outcome and prognostic factors after magnetic extraction
of posterior segment foreign bodies in 40 cases
C Chiquet,a b c
J C Zech,a
P Gain,b
P Adeleine,c
C Trepsata
a Service
d'Ophtalmologie, Clinique Universitaire A, Edouard Herriot Hospital,
Lyon, France, b Service d'Ophtalmologie, Bellevue Hospital,
Saint-Etienne, France, c Laboratoire d'Informatique médicale, Hospices
Civils de Lyon, Lyon, France
Correspondence to: Professor C Trepsat, Department of
Ophthalmology, Edouard Herriot Hospital, Place d'Arsonval, F-69437
Lyon cedex 03, France.
; Accepted for publication 22 January 1998
AIMS
To evaluate the
clinical features as well as the visual and anatomical outcome in eyes
with magnetic posterior segment foreign bodies, to identify prognostic
factors after removal using an electromagnet.
METHODS
The records of
40 patients with posterior segment foreign bodies were retrospectively
reviewed for 6 years (1989-94). Post-traumatic cataracts and secondary
retinal detachments were treated using conventional surgical
techniques. Pars plana vitrectomy was used only for late complications.
The mean follow up was 30 months (6-71). Clinical factors were studied
using univariate analysis.
RESULTS
The most
common findings before treatment of these 40 eyes were lens wound,
hyphaema, vitreous haemorrhage, and retinal impairment. The foreign
body was in the vitreous (85%) or minimally embedded in the retina
(15%). Initial visual acuity was worse or equal to 20/40 in 70% of
the cases. Subsequent to surgical treatment, a cataract was reported in
60% of the patients. Postoperative complications included retinal
detachment (15%) and phthysis (5%). The prognosis was worse in cases
with intraocular foreign body of largest diameter
3 mm, an initial
visual acuity less than 20/200, or the presence of post-traumatic
retinal detachment. Presence of initial intravitreous haemorrhage,
hyphaema, or intraocular tissue prolapse did not appear to affect the prognosis.
CONCLUSION
The long
term visual acuity results indicated that wound repair associated with
conventional magnet extraction in an emergency is a viable treatment
for posterior segment magnetic foreign bodies in this selected group.
At the time of diagnosis, size of foreign body (<3 mm) and initial
visual acuity
20/200 were predictors of good visual outcome after
primary magnetic extraction.
Keywords:
intraocular foreign body;
penetrating ocular injury;
pars plana magnetic extraction
© 1998 by British Journal of Ophthalmology