Penetrating Injury with an Intraocular Foreign Body of Organic Origin

Overview

Objective:
To demonstrate two eyes of two patients with a penetrating injury byan organic intraocular foreign body (CNT), to outline the course of treatment andto evaluate anatomical and functional results.Material and methods: During the period between May and July 1999 the authorstreated at their department an 11-year-old girl and a 17-year old boy with a penet-rating CNTinjury of organic origin. In the girl they extracted a CNTwhich piercedthe sclera and protruded into the vitreous body. The foreign body was extractedby means of a forceps, the site of perforation was treated by a cryosurgicalprocedure with a radial Silastic filling. The man was shot into the OL by a grainof pepper froman air-gun. The organic body in the vitreous body caused a violentinflammatory reaction in the vitreous body and retina. Early extraction of theCNT could not be made because of an adverse corneal finding which made surgeryimpossible. The progressing proliferative vitreoretinopathy (PVR) led to repeated formation of epiretinal, subretinal and cyclitic membranes which caused relap-sing detachment of the retina (OS). The foreign body was extracted during parsplana vitrectomy (PPV) by the transvitreal route using a forceps. Definite adhe-rence of the retina was achieved during the third PPV, membranectomy andimplantation of silicone oil (SO). Final functional success was achieved by elimi-nating SO and by partial perforating keratoplasty.Results: The CNT in the girl was histologically and parasitologically identified asa fibre of animal origin (animal hair or human eyelash). The follow up period issix months, VOP-5/5 nat., NOT 17 torr, bulbus undisturbed. In the second patientthe cultivation finding from the vitreous body was negative. Extensive PVRdeveloped as a result of breakdown products of the organic CNT and led torelapsing OS. Three months after the last operation the bulbus is at rest, thecorneal disc clear, the retina attached, VOL-3/60 s + 8.0 D steop., NOT 12 torr.Conclusions: The final results of treatment of severe devastating penetratinginjuries bya CNTis determinedbythe preoperative condition of the ocular tissues.CNT of organic origin damage intraocular tissues by their breakdown productsas well as by morefrequent contamination with pathological microorganisms. Ourexperience provided evidence that penetrating injuries by non-infected CNT oforganic origin have a favourable prognosis. But even relapsing and prolonged OSafter extraction of the CNT of organic origin and endophthalmitis need not leadto loss of the eye or its function.

Key words:
intraocular foreign body of organic origin, endophthalmitis