J Korean Ophthalmol Soc.  2019 Apr;60(4):348-354. 10.3341/jkos.2019.60.4.348.

Clinical Characteristics of Intraocular Foreign Bodies According to Entrance Location: Corneal vs. Non-Corneal

• Park SH
• Lee JJ
• Kwon HJ
• Lee JE
• Park SW

• KMID: 2443151
• DOI: http://doi.org/10.3341/jkos.2019.60.4.348

Abstract

PURPOSE
To investigate differences in the clinical features of post-traumatic intraocular foreign bodies (IOFBs) according to their entrance locations, specifically, those penetrating the cornea and those not penetrating the cornea.
METHODS
A retrospective chart review was performed of patients with an IOFB from January 2011 to July 2016. The patients were divided into two groups: those in whom the IOFB entered through the cornea ("corneal entrance" group) and those in whom the IOFB did not penetrate the cornea ("non-corneal entrance" group), and compared. Damage to the anterior and posterior capsule, retinal tear, and retinal detachment were analyzed, and differences in surgical techniques including the IOFB extraction route and intraocular lens implantation were recorded.
RESULTS
A total of 43 eyes (43 patients) were included, with 33 (76.7%) in the corneal entrance group and 10 (23.3%) in the non-corneal group. The posterior capsule was preserved in 24.2% (eight) of eyes in the corneal group and 80% (eight) of eyes in the non-corneal group. The corneal group had significantly more posterior capsule ruptures but dramatically fewer retinal tears (39.4%) than the non-corneal group (80% retinal tears).
CONCLUSIONS
The location of IOFB entrance is a predictable factor of lens capsule and retinal injuries.

Keyword

Entrance; Intraocular foreign body; Posterior capsule rupture; Retinal tear

MeSH Terms

Cornea
Foreign Bodies*
Humans
Lens Implantation, Intraocular
Retinal Detachment
Retinal Perforations
Retinaldehyde
Retrospective Studies
Rupture
Retinaldehyde

Figure

• 

  Figure 1 Case 1. (A) A preoperative photo of anterior segment shows 1.5 mm sized laceration at the center of cornea. (B) Computed tomography shows an intraocular foreign body in the left eye. (C) A postoperative photo of anterior segment shows an intraocular lens inserted in the ciliary sulcus. (D) There is no retinal injury in a postoperative fundus photo.

• 

  Figure 2 Case 2. (A) A preoperative photo of anterior segment shows 3 mm sized laceration in sclera which is 1 mm apart from limbus. (B) Computed tomography shows an intraocular foreign body in the right eye. (C) A postoperative fundus photo. Because of retinal tear and detachment, silicone oil was injected.

• 

  Figure 3 Schematic illustration of intraocular damage according to the entrance of intraocular foreign body (IOFB). (A) Corneal entrance; IOFB usually passed the cornea and lens. In such cases, posterior capsule of lens is ruptured commonly. However retinal tear happened less frequently due to bumpers of cornea and lens. (B) Limbal entrance, (C) Scleral entrance; because there was no bumpers of cornea and lens, incidence of retinal injury is higher.

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