Updates on the clinical management of intraocular foreign body (IOFB).

Abstract

This review aims to summarise recent literature in the past decade, focusing on new insights, management strategies, and technique modifications for intraocular foreign body (IOFB) cases. We discuss the latest epidemiological data, diagnostic assessments, and challenging presentations of IOFB. Imaging, particularly non-contrast helical computed tomography with thin cuts, is a valuable diagnostic adjunct. The administration of perioperative prophylactic systemic and intravitreal antibiotics may be useful in reducing infective endophthalmitis risk. We recommend same stage IOFB removal with primary repair within 24 hours whenever feasible. Furthermore, the latest updates on surgical planning, techniques, and instrumentation for IOFB removal, including crystalline lens management, IOFB extraction routes, and intraoperative adjuncts such as perfluorocarbon liquid, cohesive viscoelastic, and mitomycin-C are described. Various IOFB removal techniques including magnet-based, scaffold, suture-based, aspiration and bimanual methods, specialised and innovative instruments are also discussed. This review compiles the most recent advancements and techniques, offering a comprehensive update on the clinical management and surgical removal of IOFB.