Abstract

Background: Penetrating ocular injuries associated with intraocular foreign body (IOFB) can lead to severe visual loss and despite improvement in microsurgical techniques, IOFB removal is one of the most challenging procedures in ophthalmology. Objectives: The aim of this study was to evaluate the treatment outcomes of 23-gauge (23-G) pars plana vitrectomy (PPV) and intraocular SF6 gas tamponade for the management of patients with intraocular foreign body and attached retina with superior full thickness retinal breaks. Methods: In this prospective study, 23-G PPV was performed to manage patients with IOFB and attached retina and with full thickness retinal breaks. In patients with traumatic cataract and ruptured anterior and posterior lens capsule, IOFB was removed through limbal incision, yet in cases with intact lens capsule or without cataract, IOFB was removed through extended sclerotomy. Careful intraoperative barrier laser was performed and the vitreous cavity was filled with SF6 gas. All patients were followed-up for at least six months. Results: Ten eyes of ten patients were included in this study. The IOFB was removed through limbal incision in five eyes and through extended sclerotomy in five eyes. Lensectomy was done in eight eyes, in which primary intraocular lens (IOL) was implanted in seven eyes and secondary IOL (iris claw IOL) was implanted in one eye three months later. Visual acuity improved from 1.22 +/- 0.36 to 0.26 +/- 0.18 logMAR (P = 0.007). No major intra-operative or post-operative complication, such as retinal detachment or endophthalmitis, occurred. Conclusions: The 23-G PPV with intraocular SF6 gas tamponade was an effective and safe treatment modality for the management of eyes with small IOFBs and attached retina with full thickness retinal break.