The aim of this study was to investigate the causes of injuries and the characteristics of foreign body, analyze the clinical features and surgical procedures of delayed removal in pediatric intraocular foreign body (IOFB).

Medical records of pediatric ocular trauma patients with IOFB under hospitalization from January 2002 to December 2018 in Beijing Tongren Eye Center, Beijing Tongren Hospital affiliated to Capital Medical University were collected and retrospectively analyzed. There were 91 patients (91 eyes) were enrolled in this study, including 81 males (81 eyes) and 10 females (10 eyes). The average ages were (10.7±2.7) years-old with a range from 1 to 14 years. The pediatric patients were divided into groups according to traumatic causes, natures of IOFBs, IOFB retained positions, the longest diameters of IOFBs, complications after trauma and surgical procedures. The distribution of age was described by mean±standard deviation (±s). Frequency and percentage were used to describe the quantities and distributions of cases. Chi-square test was used for comparison incidence rate of endophthalmitis between explosive injury group and non-explosive injury group.

The most frequent cause of trauma was explosion, which had 55 cases (55 eyes) in total accounting for 60.4%. Among of the IOFB retained positions, there were 74 cases (74 eyes) accounting for 81.3% with IOFBs retained in vitreous cavity. Among of the natures of IOFBs, there were 29 cases (29 eyes) with earthy IOFBs, which accounting for 31.9% as the largest proportions. Multiple IOFBs can be found in 44 cases (44 eyes) accounting for 48.4%. 12 cases(12 eyes) with IOFBs were larger than or equal to 10 mm accounting for 13.2%. Of all the complications, 65 cases (65 eyes) accounting for 71.4% were retinal breaks to stand first; then 61 cases (61 eyes) were traumatic cataracts accounting for 67.0%, 47 cases (47 eyes) with retinal detachment which accounting for 51.6%, 27 cases (27 eyes) with proliferative vitreoretinopathy patients which accounting for 29.7%, and 22 cases (22 eyes) with endophthalmitis patients which accounting for 24.2%. Vitrectomy procedures were performed in 83 cases (83 eyes) accounting for 91.2%. Among of them, there were 20 cases (20 eyes) accounting for 24.1% with assistance of endoscopes; lensectomy procedures were performed in 63 cases (63 eyes) accounting for 69.2%.

Delayed removal of IOFBs in pediatric ocular trauma occurs more often in males than female, especially in school children. The principal cause of trauma was explosion. Slit, stones and fireworks accounted for the highest proportion of IOFBs. IOFB retained in posterior segment was the main reason for delayed removal. Many complications were along with trauma, such as traumatic cataract, retinal break, retinal detachment, proliferative vitreoretinopathy and endophthalmitis. Vitrectomy combined with lensectomy was the most common surgical procedure. Pediatric ocular trauma with IOFB had lots of complications and the treatments were complicated. Therefore, the active prevention of pediatric ocular trauma was important.