Sir,
We appreciate the comments of Dr Agrawal and Dr Laude1 on our paper.2 Indications of enucleation in four cases of our reviewed study were no light perception vision with extensively exposed uveal and retinal tissues accompanied by multiple facial bone injuries. Owing to the development of ophthalmic instruments and surgical techniques, primary ocular repair is the aim of penetrating ocular injuries in clinical practice. However, severe ocular injuries in some conditions may result in irretrievable reconstruction. Although the current trend leans toward evisceration because of the rarity of sympathetic ophthalmia and better cosmetic outcome compared with enucleation, the preference of these procedures is still controversial.3, 4 Savar et al5 reported 51 and 5 enucleation and evisceration cases among 660 traumatized eyes, respectively. In contrast, Toit et al6 reported primary enucleation in 3 eyes and evisceration in 491 eyes, respectively. The decision should be considered for selected cases based on the different conditions of the patients.
We reported the delay in IOFB removal because of timing limitation by referral or consultation in the setting of no prophylactic intravitreal antibiotic injections unless there were signs of endophthalmitis. The management of intraocular foreign body has been reviewed. The decision to administer intravitreal antibiotics should be considered in high-risk setting.7, 8 Consequently, the acceptable endophthalmitis rate of 9.1% in this study may depend on domestic type of injury and prophylactic systemic antibiotic application with no intravitreal antibiotic injections. However, the definite role of giving intravitreal antibiotic prophylaxis in eyes suffering from different types of IOFB had not been explored in this limited data study.
We realize the importance of meticulous primary ocular repair procedures and the removal of foreign bodies in the available situations to get rid of possible complications. The data from prospective or a retrospective cohort study in the future may provide more evidence in some controversial points.
References
Agrawal R, Laude A . Predictive factors and outcomes for posterior segment intraocular foreign bodies. Eye 2012; 26 (5): 751–752.
Choovuthayakorn J, Hansapinyo L, Ittipunkul N, Patikulsila D, Kunavisarut P . Predictive factors and outcomes of posterior segment intraocular foreign bodies. Eye 2011; 25: 1622–1626.
Soares IP, França VP . Evisceration and enucleation. Semin Ophthalmol 2010; 25 (3): 94–97.
McClenaghan FC, Ezra DG, Holmes SB . Mechanisms and management of vision loss following orbital and facial trauma. Curr Opin Ophthalmol 2011; 22 (5): 426–431.
Savar A, Andreoli MT, Kloek CE, Andreoli CM . Enucleation for open globe injury. Am J Ophthalmol 2009; 147 (4): 595–600.
du Toit N, Motala MI, Richards J, Murray AD, Maitra S . The risk of sympathetic ophthalmia following evisceration for penetrating eye injuries at Groote Schuur Hospital. Br J Ophthalmol 2008; 92 (1): 61–63.
Yeh S, Colyer MH, Weichel ED . Current trends in the management of intraocular foreign bodies. Curr Opin Ophthalmol 2008; 19 (3): 225–233.
Woodcock M, Scott R, Huntbach J, Kirkby G . Mass and shape as factors in intraocular foreign body injuries. Ophthalmology 2006; 113 (12): 2262–2269.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Choovuthayakorn, J., Hansapinyo, L., Ittipunkul, N. et al. Response to Comment on ‘Predictive factors and outcomes of posterior segment intraocular foreign bodies’. Eye 26, 752–753 (2012). https://doi.org/10.1038/eye.2012.31
Published:
Issue Date:
DOI: https://doi.org/10.1038/eye.2012.31
