When should delayed removal of an intraocular foreign body be considered?

If you are deciding whether to close the globe first and then remove the IOFB with a later surgery, then first consider the type of IOFB and its potential to incite infection or inflammation. No matter what type of IOFB it is, the team repairing the ruptured globe should inject intravitreal broad-spectrum antibiotics at the time of closure.

Types of IOFB:

Organic (wood or plant matter) - common in construction or landscaping-related injuries. Remove IOFB as soon as possible and always inject in...

Primary globe closure with delayed removal of posterior IOFB can be considered in an uninfected eye in the following scenarios:

1. Unavailability of a vitreo-retinal surgical team to perform such a case (transfer to a facility where IOFB removal can be performed should be considered after primary repair).

2. Severe corneal opacification (with a plan to remove of IOFB with a combined PKP or endoscope, if the opacification does not improve within days).

3. A medically unstable patient who cannot u...

If vitreoretina team is unavailable or unable due to lack of visualization.