Advances in the management of intraocular foreign bodies

Front Ophthalmol (Lausanne). 2024 Sep 2:4:1422466. doi: 10.3389/fopht.2024.1422466. eCollection 2024.

Abstract

Intraocular foreign bodies (IOFBs) remain a severe complication of ocular trauma commonly encountered worldwide. This literature review aimed to discuss current practice patterns, areas of controversy, and advances in the management of IOFBs. Injuries involving IOFBs carry significant ocular morbidity and management can be extremely challenging. A systematic approach to preoperative evaluation and IOFB surgical management is detailed in this article and should be applied in each case. The location and composition of an IOFB have important implications on surgical approach and timing, especially in cases of toxic metals and vegetable matter. The advantages, disadvantages, and previous literature regarding immediate versus delayed foreign body removal are presented. Surgical approaches are described, with an emphasis on posterior chamber IOFB management and removal via pars plana vitrectomy. Final visual acuity is variable, but approaches have been used to prognosticate outcomes including the Ocular Trauma Score. By synthesizing current IOFB literature, the goal is to provide practitioners with guidance that will maximize the chances of surgical success and patient outcomes.

Keywords: endophthalmitis; intraocular foreign body; ocular trauma; open globe injury; vitrectomy.

Publication types

  • Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The authors declare that this study received funding from the National Eye Institute of the National Institutes of Health under award number R01 EY029594 (SY). Grant support is also provided by the Macula Society Retina Research Foundation, ARVO Mallinckrodt Young Investigator Grant, and the Stanley M. Truhlsen Family Foundation, Inc (SY). CC was supported in part by a Knights Templar Eye Foundation career development award and competitive renewal, IDeA-CTR career development award, and National Eye Institute of the National Institutes of Health award number K08 EY034892. The funders were not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.