Retained Intraocular Foreign Body
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Ocular trauma is an important cause of preventable visual impairment worldwide. An estimated 2.4 million cases occur every year in the USA, with serious vision-threatening injuries ranging from 20,000 to 68,000 of these. Most cases presented in a study by the National Eye Trauma System Registry were seen in young male patients and happened in a home or workplace setting (Parver et al. 1993); therefore, the economic and social burden of this topic cannot be overstated. According to the Birmingham Eye Trauma Terminology (BETT) system, intraocular foreign bodies (IOFBs) or retained foreign objects are a subset of penetrating injuries, when there is an entrance wound without an exit wound (Kuhn et al. 2004). They account for 14–43% of open-globe injuries (OGIs) (Patel et al. 2012; Zhang et al. 2011; Shock and Adams 1985) and pose challenging surgical cases in which the goal is to remove the foreign body (FB) while attempting to preserve vision and restore ocular architecture (Greven et al. 2000). The most common site of entry is the cornea (65%), followed by the sclera (25%) and the limbus (10%) (Rathod and Mieler 2011). Most IOFBs are seen in the posterior segment (Katz and Moisseiev 2009; Zhang et al. 2011) but can also be found in the anterior chamber or even in the lens (Fig. 9.1). The composition of IOFBs differ, ranging from organic material such as wood and insect parts to inert substances like plastic and glass, but most of them are metallic in nature (Greven et al. 2000; Woodcock et al. 2006).
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