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      Posterior Segment Intraocular Foreign Body: Extraction Surgical Techniques, Timing, and Indications for Vitrectomy

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          Abstract

          Ocular penetrating injury with Intraocular Foreign Body (IOFB) is a common form of ocular injury. Several techniques to remove IOFB have been reported by different authors. The aim of this publication is to review different timing and surgical techniques related to the extraction of IOFB. Material and Methods. A PubMed search on “Extraction of Intraocular Foreign Body,” “Timing for Surgery Intraocular Foreign Body,” and “Surgical Technique Intraocular Foreign Body” was made. Results. Potential advantages of immediate and delayed IOFB removal have been reported with different results. Several techniques to remove IOFB have been reported by different authors with good results. Conclusion. The most important factor at the time to perform IOFB extraction is the experience of the surgeon.

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          Most cited references25

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          The Ocular Trauma Score (OTS).

          Only based on a standardized terminology of ocular trauma terms, and using a very large number of injuries treated by a wide variety of ophthalmologists, could a reliable method be developed so that the functional outcome of a serious eye injury can be predicted with reasonable certainty. The authors used the databases of the United States and Hungarian Eye Injury Registries and, with a grant from the National Center for Injury Prevention at the Centers for Disease Control and Prevention, designed such a system.
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            Intraocular foreign bodies: A review

            Intraocular foreign body injuries may result in a wide range of intraocular pathology and visual outcomes based on the mechanism of injury, type of foreign body, and subsequent complications. We have reviewed the literature to describe the epidemiology and mechanisms of such injuries; types of foreign bodies; imaging tools for diagnosis; current trends in management, presurgical, and surgical interventions; as well as visual prognosis and potential complications. The purpose of this review is to familiarize clinicians with the recent advances in diagnosis and management of such injuries.
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              Current trends in the management of intraocular foreign bodies.

              The aim of this article is to present the recent literature on the preoperative assessment, intraoperative management and postoperative care of patients with intraocular foreign bodies and present a management algorithm. The preoperative assessment includes an evaluation of concomitant, potentially life-threatening conditions, as well as a relevant history and ophthalmic examination. Neuroimaging, preferably with noncontrast helical computed tomography, provides excellent information about intraocular foreign body size, shape and location. The preoperative assessment provides valuable information for prognosis, counseling, and intraoperative guidance. The decision of delayed versus immediate intraocular foreign body removal must be guided by the patient's medical status, availability of adequate operating facilities and staff, and the presence of clinical endophthalmitis. The administration of perioperative systemic and topical third or fourth-generation fluoroquinolones may play a role in decreasing the incidence of postoperative endophthalmitis. Intravitreal antibiotics warrant consideration in patients with a Gram stain positive for organisms, in cases suspicious for endophthalmitis, and in high-risk settings. Both the material and size of the foreign body are considerations in the choice of instrument and extraction site used (sclerotomy versus scleral tunnel) at time of pars plana vitrectomy and intraocular foreign body removal. Postoperatively, patients should be monitored closely for the development of endophthalmitis, retinal detachment and proliferative vitreoretinopathy. This review summarizes the recent literature on the assessment of intraocular foreign bodies and techniques for their removal. An algorithm provides guidelines for their perioperative and operative management.
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                Author and article information

                Journal
                J Ophthalmol
                J Ophthalmol
                JOPH
                Journal of Ophthalmology
                Hindawi Publishing Corporation
                2090-004X
                2090-0058
                2016
                29 November 2016
                : 2016
                : 2034509
                Affiliations
                Instituto de Oftalmología y Ciencias Visuales, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Monterrey, NL, Mexico
                Author notes
                *Patricio J. Rodríguez-Valdés: dr.patriciorodriguez@ 123456gmail.com

                Academic Editor: Robert Rejdak

                Author information
                http://orcid.org/0000-0002-6652-9631
                Article
                10.1155/2016/2034509
                5153482
                28025619
                8746a73c-8142-4a84-8bc3-a8987070c41c
                Copyright © 2016 D. A. Guevara-Villarreal and P. J. Rodríguez-Valdés.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 5 September 2016
                : 18 October 2016
                Categories
                Review Article

                Ophthalmology & Optometry
                Ophthalmology & Optometry

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