Clinical profile and outcomes of posterior segment metallic intraocular foreign bodies following chisel-hammer injury managed with pars plana vitrectomy.

Authors

Aarshi Naharwal, Ramanuj Samanta, Mansi Pandey, Sreeram Jayaraj, Shalaka Ramesh Waghamare, Ajai Agrawal

Published in

Indian journal of ophthalmology. Volume 74. Issue Suppl 3. Pages S442-S448. Oct 01, 2026. Epub Oct 02, 2026.

Abstract

Chisel hammer injury-associated retained intraocular foreign bodies (CHI-IOFBs) are a major occupational health hazard and can lead to significant visual decline. The objective of the current study was to evaluate the anatomical and functional outcomes of pars plana vitrectomy (PPV) in posterior segment CHI-IOFB.
This was a retrospective case series over 5 years involving patients who underwent 23-gauge PPV for CHI-IOFB. Patients with <3 months of follow-up after PPV were excluded.
Overall, 29 patients (mean age 29.2 years, 96.6% male) underwent PPV. At presentation, 21 each had traumatic cataract and vitreous hemorrhage (VH), seven had retinal detachment (RD), six had endophthalmitis, and two had siderosis. The median time of PPV after injury was 7.1 days. 44.8% underwent concurrent primary repair and IOFB removal, while 55.2% underwent IOFB removal at a second stage. IOFB could be removed in all patients except four due to a deep-seated location. 82.8% patients required lens removal to facilitate IOFB removal. Favorable anatomical outcome was achieved in 89.6% patients. The mean best-corrected visual acuity (BCVA) (logMAR) improved significantly (P < 0.001) from preoperative 2.4 to postoperative 1.2. The interval between primary repair and PPV, baseline BCVA, preoperative VH, and postoperative macular pucker were significantly associated with final visual outcome, while preoperative RD, subretinal bleed, and endophthalmitis were not associated with final visual outcome.
Although limited by a relatively small retrospective cohort, the current study showed that early PPV with appropriate adjunctive measures significantly improved anatomical and functional outcomes in most CHI-IOFB cases. RD, endophthalmitis, and siderosis were major complications associated with CHI-IOFB at presentation. Deep-seated IOFB beyond the optic nerve head or post-equatorial scleral coats posed surgical challenges in IOFB retrieval, highlighting the importance of appropriate preoperative imaging and evaluation in cases with complex posterior segment CHI-IOFB.

PMID:
42825767
Bibliographic data and abstract were imported from PubMed on 02 Oct 2026.

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