Extraction Routes of Intraocular Foreign Body

NCT ID: NCT05966545

Last Updated: 2023-07-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-01-01

Study Completion Date

2023-09-30

Brief Summary

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Intra ocular foreign body removal is indicated to avoid further many complications such as retinal detachment, endophthalmitis. The surgical approach for a posterior segment IOFB is pars plana vitrectomy and its extraction either through the pars plana. our study is to compare limbal route versus pars plana route for extraction of posterior segment IOFB associated with cataract as regard to safety and complications.

Detailed Description

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Penetrating ocular injuries with retained posterior segment intraocular foreign body (IOFB) are relatively common and account for 17% to 41% of ocular injuries.

Intra ocular foreign body removal is indicated to avoid further many complications such as retinal detachment, endophthalmitis, retinal toxicity (secondary to chalcosis, siderosis) and sympathetic ophthalmia.

The surgical approach for a posterior segment IOFB is pars plana vitrectomy (PPV) and its extraction either through the pars plana or the limbus.

PPV and IOFB extraction through sclerotomy is the most commonly used approach. Most commonly retained posterior segment intra ocular foreign bodies (IOFB) are removed after enlarging one of the sclerotomy ports during pars plana vitrectomy. Intra operative complications reported during IOFB extraction were hypotony, vitreous hemorrhage, incarceration of the retina in the wound, IOFB slippage. Reported post-operative complications were glaucoma and retinal detachment. Incidence of post-operative RD was reported to range from 22% to 79% with poor visual outcomes in most cases PPV and IOFB extraction through the limbal route is an alternative approach to remove IOFB. Complications reported were less frequent and include microscopic hyphema and vitreous hemorrhage. The incidence of post-operative retinal detachment after IOFB extraction through limbus was reported to range from 7.15% to 27.7 % The limbal route for retained posterior segment IOFB extraction can offer the following advantages: it allows visually controlled delivery of the IOFB from the posterior pole to the limbal exit and it has no relation to the vitreous base, thus minimizing the risk of creating a peripheral retinal break during extraction of intraocular foreign body, in contrast to the hidden part behind the iris when using the pars plana route.

Conditions

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Intraocular Foreign Body

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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intraocular foreign body extraction via the limbus

pars plana vitrectomy and intraocular foreign body removal via the limbus, after complete removal of adhesions around intraocular foreign body, then the foreign body will be grasped using basket forceps, and it will be brought to anterior chamber and then removed through limbal incision. The external earth magnet will be applied close to the limbus to prevent its slippage from the forceps if needed.

Group Type ACTIVE_COMPARATOR

pars plana vitrectomy and intraocular foreign body removal

Intervention Type PROCEDURE

removal of vitreous body and attachment to foreign body then extraction of foreign body

intraocular foreign body extraction via the pars plana route

pars plana vitrectomy and intraocular foreign body removal via pars plana route, after complete removal of adhesions around intraocular foreign body, then IOFB will be grasped using basket forceps, and while the IOFB removed through the sclerotomy an external earth magnet will be applied close to the sclerotomy after enlargement the sclerotomy to prevent its slippage from the forceps and falling down onto the posterior pole if needed.

Group Type ACTIVE_COMPARATOR

pars plana vitrectomy and intraocular foreign body removal

Intervention Type PROCEDURE

removal of vitreous body and attachment to foreign body then extraction of foreign body

Interventions

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pars plana vitrectomy and intraocular foreign body removal

removal of vitreous body and attachment to foreign body then extraction of foreign body

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Eyes with retained posterior segment intraocular foreign body associated with crystalline lens injury.
* Eyes with retained posterior segment intraocular foreign body associated with coexisting cataract.

Exclusion Criteria

* Eyes with pre-operative retinal detachment
* Eyes with retained posterior segment IOFB with clear lens.
* Anterior segment IOFBs
* Severely damaged eyes with an initial visual acuity of no light perception where enucleation is the primary treatment
* Patients with severely traumatized cornea which can affect visualization during vitrectomy.
* Pseudophakic eyes.
* Eyes with endophthalmitis
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Zagazig University

OTHER_GOV

Sponsor Role lead

Responsible Party

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Abbas Abomesslam Ali Hashem

assistant lecturer

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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sherif A. Dabour, MD

Role: STUDY_DIRECTOR

Zagazig University

Ahmad S. Khalil, MD

Role: STUDY_DIRECTOR

Zagazig University

Locations

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faculty of medicine, Zagazig university

Zagazig, Sharqia Province, Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Abbas A. Ali Hashem, MSc

Role: CONTACT

Phone: 01066227749

Email: [email protected]

Wael M. El haig, MD

Role: CONTACT

Phone: 01222155744

Email: [email protected]

Facility Contacts

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Abbas A. Ali Hashem, Msc

Role: primary

Wael M. EL Haig, MD

Role: backup

References

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Demircan N, Soylu M, Yagmur M, Akkaya H, Ozcan AA, Varinli I. Pars plana vitrectomy in ocular injury with intraocular foreign body. J Trauma. 2005 Nov;59(5):1216-8. doi: 10.1097/01.ta.0000196438.48182.ff.

Reference Type BACKGROUND
PMID: 16385302 (View on PubMed)

Loporchio D, Mukkamala L, Gorukanti K, Zarbin M, Langer P, Bhagat N. Intraocular foreign bodies: A review. Surv Ophthalmol. 2016 Sep-Oct;61(5):582-96. doi: 10.1016/j.survophthal.2016.03.005. Epub 2016 Mar 17.

Reference Type BACKGROUND
PMID: 26994871 (View on PubMed)

Wani VB, Al-Ajmi M, Thalib L, Azad RV, Abul M, Al-Ghanim M, Sabti K. Vitrectomy for posterior segment intraocular foreign bodies: visual results and prognostic factors. Retina. 2003 Oct;23(5):654-60. doi: 10.1097/00006982-200310000-00008.

Reference Type BACKGROUND
PMID: 14574250 (View on PubMed)

Wickham L, Xing W, Bunce C, Sullivan P. Outcomes of surgery for posterior segment intraocular foreign bodies--a retrospective review of 17 years of clinical experience. Graefes Arch Clin Exp Ophthalmol. 2006 Dec;244(12):1620-6. doi: 10.1007/s00417-006-0359-6.

Reference Type BACKGROUND
PMID: 16788826 (View on PubMed)

Other Identifiers

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ZU-IRB#9040/24-10-24

Identifier Type: -

Identifier Source: org_study_id