The clinical feature and early operative management of perforating injury of eyeball by metallic foreign body

Objective To investigate the clinical features of perforating injury of eyeball by metallic foreign body,together with the discussion of the primary treatment,the vitreoretinal surgery time,the surgical technique and the therapeutic evaluation.Method Medical records of 15 cases ( 16 eyes) of ocular perforating injury by metallic foreign body were retrospectively analyzed.Results The follow-up was from 2 week to 2 years.Two cases that had not undergone surgery were resulted in a corrected visual acuity of 0.8.Fourteen patients gained visual acuity increase after operation.The retina reattached in 12 eyes after the first pars plana vitrectomy (PPV),and in 2 eyes after the secondary PPV.Two foreign bodies on eyeball wall and 3 foreign bodies in orbit were extracted.There was no complication observed in 11 cases with foreign bodies persist in orbit.Conclusion For perforating injury with mild vitreous hemorrhage,medicine treatment was used if the wound can be self-closed.For perforating injury with serious vitreous hemorrhage,it is proper to perform vitreoretinal surgery between 7 - 14 days later.For perforating injury with retinal detachment or with infection sign,it is proper to carry out vitreoretinal surgery as early as possible.It is a welladvised choice to pack the postern scleral wound by gelatin sponge.Inert gas or silicone oil tamponade were used according to the condition of vitreous body and retina. Key words: Perforating injury, eyeball;  Foreign body, metallic ;  Clinical feature ;  Operative management