Clinical characteristics of posterior segment penetrating eye injuries treated in tertiary referral hospital in Serbia

Background/Aim. Ocular trauma is a significant cause of visual impairment worldwide. The aim of the study was to analyze clinical characteristics of patients with penetrating eye injuries with retained intraocular foreign body (IOFB) in posterior segment of the eye. Methods. The retrospective study...

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Main Authors: Kovačević Igor, Radosavljević Aleksandra, Karadžić Jelena, Stefanović Ivan, Vukadinović Jovana
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2020-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501800193K.pdf
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author Kovačević Igor
Radosavljević Aleksandra
Karadžić Jelena
Stefanović Ivan
Vukadinović Jovana
author_facet Kovačević Igor
Radosavljević Aleksandra
Karadžić Jelena
Stefanović Ivan
Vukadinović Jovana
author_sort Kovačević Igor
collection DOAJ
description Background/Aim. Ocular trauma is a significant cause of visual impairment worldwide. The aim of the study was to analyze clinical characteristics of patients with penetrating eye injuries with retained intraocular foreign body (IOFB) in posterior segment of the eye. Methods. The retrospective study enrolled medical records of consecutive patients hospitalized in a five year period (2012–2016) in a tertiary referral center in Serbia. Surgical repair included pars plana vitrectomy and IOFB removal. Postoperative results were evaluated using the best corrected visual acuity (BCVA). Results. Out of 130 patients who suffered penetrating eye injury with retained IOFB, 72 had IOFB in posterior segment of the eye (43 in retina, 25 in vitreous, 3 in ciliary body, 1 on the optic nerve). Patients were predominantly young adults (aged 44.3 ± 14.9 years, 97.2% men). Average BCVA at admission was poor (0.27 ± 0.38, measured by Snellen chart), and 52.8% of patients had BCVA of counting fingers at 1 meter or less. The majority of patients had corneal wound (70.8%), medium sized IOFB (48.6%), iris injury (61.1%) and traumatic cataract (69.4%). Complications included retinal detachment (16.7%) and endophthalmitis (15.3%). Two patients had the eye enucleated due to severe endophthalmitis, which could not be otherwise controlled. Significant risk factors for postoperative outcome were: initial BCVA (p < 0.001), ocular hypotony (p = 0.013), medium size of IOFB (p = 0.037), presence of traumatic cataract (p = 0.036), retinal detachment (p = 0.032) and endophthalmitis (p = 0.045). Conclusion. Treatment of posterior segment penetrating eye injuries remains a challenge due to high frequency of low initial visual acuity, retinal detachment and endophthalmitis, all of which are risk factors for poor visual outcome. Patients with better initial BCVA, normal intraocular pressure and small IOFB have better postoperative results.
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spelling doaj-art-c19d0fc0abd34a559f71681fb723b26f2025-08-20T03:23:30ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202020-01-0177121245125110.2298/VSP181027193K0042-84501800193KClinical characteristics of posterior segment penetrating eye injuries treated in tertiary referral hospital in SerbiaKovačević Igor0Radosavljević Aleksandra1Karadžić Jelena2Stefanović Ivan3Vukadinović Jovana4Clinical Center of Serbia, Hospital for Eye Diseases, Department for Ocular Trauma and Vitreoretinal Surgery, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Ophthalmology Department, Belgrade, SerbiaClinical Center of Serbia, Hospital for Eye Diseases, Department for Ocular Trauma and Vitreoretinal Surgery, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Ophthalmology Department, Belgrade, SerbiaClinical Center of Serbia, Hospital for Eye Diseases, Department for Ocular Trauma and Vitreoretinal Surgery, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Ophthalmology Department, Belgrade, SerbiaClinical Center of Serbia, Hospital for Eye Diseases, Department for Ocular Trauma and Vitreoretinal Surgery, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Ophthalmology Department, Belgrade, SerbiaClinical Center of Serbia, Hospital for Eye Diseases, Department for Ocular Trauma and Vitreoretinal Surgery, Belgrade, SerbiaBackground/Aim. Ocular trauma is a significant cause of visual impairment worldwide. The aim of the study was to analyze clinical characteristics of patients with penetrating eye injuries with retained intraocular foreign body (IOFB) in posterior segment of the eye. Methods. The retrospective study enrolled medical records of consecutive patients hospitalized in a five year period (2012–2016) in a tertiary referral center in Serbia. Surgical repair included pars plana vitrectomy and IOFB removal. Postoperative results were evaluated using the best corrected visual acuity (BCVA). Results. Out of 130 patients who suffered penetrating eye injury with retained IOFB, 72 had IOFB in posterior segment of the eye (43 in retina, 25 in vitreous, 3 in ciliary body, 1 on the optic nerve). Patients were predominantly young adults (aged 44.3 ± 14.9 years, 97.2% men). Average BCVA at admission was poor (0.27 ± 0.38, measured by Snellen chart), and 52.8% of patients had BCVA of counting fingers at 1 meter or less. The majority of patients had corneal wound (70.8%), medium sized IOFB (48.6%), iris injury (61.1%) and traumatic cataract (69.4%). Complications included retinal detachment (16.7%) and endophthalmitis (15.3%). Two patients had the eye enucleated due to severe endophthalmitis, which could not be otherwise controlled. Significant risk factors for postoperative outcome were: initial BCVA (p < 0.001), ocular hypotony (p = 0.013), medium size of IOFB (p = 0.037), presence of traumatic cataract (p = 0.036), retinal detachment (p = 0.032) and endophthalmitis (p = 0.045). Conclusion. Treatment of posterior segment penetrating eye injuries remains a challenge due to high frequency of low initial visual acuity, retinal detachment and endophthalmitis, all of which are risk factors for poor visual outcome. Patients with better initial BCVA, normal intraocular pressure and small IOFB have better postoperative results.http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501800193K.pdfendophthalmitiseye foreign bodieseye injuriesretinal detachmentrisk factorstreatment outcome
spellingShingle Kovačević Igor
Radosavljević Aleksandra
Karadžić Jelena
Stefanović Ivan
Vukadinović Jovana
Clinical characteristics of posterior segment penetrating eye injuries treated in tertiary referral hospital in Serbia
Vojnosanitetski Pregled
endophthalmitis
eye foreign bodies
eye injuries
retinal detachment
risk factors
treatment outcome
title Clinical characteristics of posterior segment penetrating eye injuries treated in tertiary referral hospital in Serbia
title_full Clinical characteristics of posterior segment penetrating eye injuries treated in tertiary referral hospital in Serbia
title_fullStr Clinical characteristics of posterior segment penetrating eye injuries treated in tertiary referral hospital in Serbia
title_full_unstemmed Clinical characteristics of posterior segment penetrating eye injuries treated in tertiary referral hospital in Serbia
title_short Clinical characteristics of posterior segment penetrating eye injuries treated in tertiary referral hospital in Serbia
title_sort clinical characteristics of posterior segment penetrating eye injuries treated in tertiary referral hospital in serbia
topic endophthalmitis
eye foreign bodies
eye injuries
retinal detachment
risk factors
treatment outcome
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501800193K.pdf
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