Clinical outcomes and characterization of intraocular foreign body injuries from a Canadian centre: a 20-year retrospective study and literature review.

Abstract

Objective: To analyse assessment and management patterns of intraocular foreign body (IOFB) injuries in an urban Canadian setting, providing valuable clinical insights to contextualize management.

Methods: Single-surgeon retrospective chart review from January 2002 to January 2023 examining IOFB patient demographics, investigations, treatments, complications, and best-corrected visual acuity (BCVA).

Results: This study evaluated IOFBs in 32 eyes from 31 patients (96.8% male). Sizes ranged from 1 to 12 mm; 28 (87.5%) were metallic and 15 (46.9%) were work-related injuries. For diagnosis, 19 patients (61.3%) underwent computed tomography (CT) imaging, and 8 (25.8%) received B-scans, with CT detecting IOFBs in 100% of cases and B-scan in 87.5%. At final follow-up, 17 eyes (53.1%) achieved BCVA ≥20/40, up from 7 (23.3%) initially. Presenting BCVA ≥20/200 was associated with a final BCVA ≥20/40 (P = 0.027). The IOFB was extracted in 27 eyes (84.4%), retained in 4 (12.5%), and 1 (3.1%) required enucleation. Intravitreal antibiotics were administered in 19 eyes (59.4%), resulting in one presumed case of drug toxicity. Complications were present in 30 eyes (93.8%), totalling 119 recorded overall, with 72 (60.5%) occurring within the first 24 hours. Traumatic cataracts were most common in 27 eyes (84.4%). Less-common complications included siderosis and retinal detachment with proliferative vitreoretinopathy, each occurring in one eye (3.1%). Four eyes (12.5%) developed secondary glaucoma, with 3 cases in retained or delayed extractions.

Conclusions: The IOFB characteristics and patient demographics are consistent with other regions. CT scans were the most effective investigation tool. Extended follow-up is recommended to monitor complications, particularly in retained or significantly delayed extractions.