Predictive Factors for Structural and Functional Outcomes of 25-Gauge Pars Plana Vitrectomy (PPV) for the Removal of Posterior Intraocular Foreign Bodies (IOFBs): A Retrospective Data Analysis From North India

Purpose: To identify predictive factors for structural and functional outcomes of 25-gauge pars plana vitrectomy (25G PPV) for removal of posterior segment intra-ocular foreign body (IOFB).

Methodology: A retrospective data analysis was performed for patients undergoing 25G PPV for removal of posterior segment IOFB between August 2019 to June 2021. Necessary demographic details and data regarding pre-operative ophthalmic examination were recorded. Similarly, intraoperative surgical details were recorded. Postoperative outcome measures included final best corrected visual acuity (BCVA), retinal status, and epiretinal membrane formation at the last follow-up visit. A univariate analysis was applied to find the association of various independent variables with functional and structural outcomes.

Results: Thirty-nine patients were included in the study, with 37 males and two females. The mean age of the study group was 30.5+10.8 years. The most common zone of open globe injury was zone 1. Most of the impactions of IOFB were seen outside the macular area. Preoperative BCVA was 2.23+0.58 logarithm of the Minimum Angle of Resolution (logMAR), which improved significantly to 1.01+0.53 in the postoperative period (p-value <0.001). Anatomical success was achieved in 92.3% of patients at one year follow-up. The presence of impacted IOFB, associated endophthalmitis and IOFB >4mm were associated with poor visual outcomes (univariate analysis; p-value <0.05). None of the factors affected the anatomical success rates.

Conclusion: The presence of impacted IOFB, associated endophthalmitis, and large IOFB (>4mm) were associated with poor visual outcomes with 25G PPV for removal of IOFB.