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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



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