Retained intraorbital metallic foreign bodies.

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  • Author(s): Ho VH;Ho VH; Wilson MW; Fleming JC; Haik BG
  • Source:
    Ophthalmic plastic and reconstructive surgery [Ophthalmic Plast Reconstr Surg] 2004 May; Vol. 20 (3), pp. 232-6.
  • Publication Type:
    Journal Article; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Lippincott Williams & Wilkins for the American Society of Ophthalmic Plastic and Reconstructive Surgery Country of Publication: United States NLM ID: 8508431 Publication Model: Print Cited Medium: Print ISSN: 0740-9303 (Print) Linking ISSN: 07409303 NLM ISO Abbreviation: Ophthalmic Plast Reconstr Surg Subsets: MEDLINE
    • Publication Information:
      Publication: 199 - : Hagerstown, MD : Lippincott Williams & Wilkins for the American Society of Ophthalmic Plastic and Reconstructive Surgery
      Original Publication: [New York, NY : Raven Press Publishers], c1985-
    • Subject Terms:
      Metals*; Eye Foreign Bodies/*physiopathology ; Foreign Bodies/*physiopathology ; Orbital Diseases/*physiopathology; Adaptation, Physiological ; Adolescent ; Adult ; Child ; Child, Preschool ; Contusions/surgery ; Eye Enucleation ; Eye Foreign Bodies/surgery ; Eye Injuries/surgery ; Female ; Foreign Bodies/surgery ; Humans ; Male ; Middle Aged ; Orbital Diseases/surgery ; Prognosis ; Retrospective Studies ; Visual Acuity ; Wounds, Penetrating/surgery
    • Abstract:
      Purpose: To document the biological tolerance of retained metallic orbital foreign bodies managed with conservative treatment.
      Methods: A retrospective chart review of 43 patients treated between 1987 and 1993 with retained intraorbital metallic foreign bodies was performed. Age, sex, injury, imaging studies obtained, location of the foreign body, initial and final visual acuity, length of follow-up, treatment, and related adverse reactions and/or complications were recorded.
      Results: Fifty cases involving 34 male and 9 female patients ranging in age from 2 through 63 years (median, 25 years) were included. Seventeen cases were the result of gunshot wounds, 17 were from BB gun injuries, and 16 cases were from shotgun injuries. Forty-two patients had CT scans to assess the injury and one patient had plain radiographs. In 37 cases, the metallic foreign bodies were located posterior to the globe. There were 19 ocular penetrating injuries, 11 ocular contusion injuries (sclopetaria, commotio retinae, vitreous hemorrhages), and 20 injuries with no ocular involvement. Initial visual acuity ranged from 20/20 to no light perception, as did final visual acuity. The metallic foreign bodies were retained from 6 months to 68 years (median, 2 years). There were 19 ocular penetrating injuries, including 12 enucleations and 7 primary repairs. When contusion injuries were sustained, treatment consisted of vitrectomy for the removal of persistent hemorrhages (3 cases), exploration of the globe (1 case), and nonsurgical treatment (7 cases). Among the 20 cases with no ocular involvement, only 2 patients had secondary complications that required surgical intervention: One had mechanical strabismus, the other a sterile abscess. Visual acuity remained stable or improved in all cases. There were no late complications from the retained foreign bodies in 36 (95%) of 38 cases when the eye remained intact.
      Conclusions: Retained intraorbital metallic foreign bodies are well-tolerated and typically have minimal adverse visual prognosis. They should be managed conservatively in the absence of specific indications for removal.
    • Accession Number:
      0 (Metals)
    • Publication Date:
      Date Created: 20040529 Date Completed: 20040702 Latest Revision: 20220408
    • Publication Date:
      20240829
    • Accession Number:
      10.1097/01.iop.0000129014.94384.e6
    • Accession Number:
      15167733