Clinical Characteristics and Prognostic Factors for Visual Outcome in Intraocular Foreign Body Cases Treated at a Tertiary Eye Hospital in Indonesia

Objective: Intraocular foreign bodies (IOFB) remain a significant cause of visual impairment worldwide. The complex nature of IOFB cases poses considerable management challenges, contributing to various outcomes. This study aimed to determine clinical characteristics and prognostic factors associated with visual outcomes following IOFB treatments. Methods and Analysis: We conducted a retrospective review of IOFB patients admitted between January 2019 - January 2024 at a tertiary hospital in Indonesia. Medical records were evaluated based on predefined inclusion and exclusion criteria. Results: A total of forty-six patients (46 eyes) were analyzed, of which 76.1% had metallic IOFBs (35 eyes), predominantly caused by hammering metal (70%). Cornea was the most frequent entry site (31 eyes). The mean preoperative best-corrected visual acuity (BCVA) was 1.74 ± 1.01 (logMAR), improving to 1.28 ± 1.03 at the final follow-up. Univariate analysis showed larger IOFB size, worse initial BCVA, longer injury-to-surgery intervals, higher complications, endophthalmitis, traumatic cataract, secondary glaucoma, and primary surgery with lensectomy were significantly associated with poor final BCVA. Multiple logistic regression identified poor baseline BCVA and the need of additional lensectomy procedure as independent risk factors for lower final BCVA. Conclusion: Lower preoperative BCVA and concomitant lensectomy subsequent to IOFB removal were significant predictors of poor visual prognosis. Plain Language Summary: What is Already Known on this Topic IOFBs are a major cause of visual loss in open-globe injuries, with visual outcomes influenced by factors such as IOFB size, material, location, associated complications, and timing of surgery. However, data from Indonesia remain limited despite a high burden of ocular trauma in the region. What this Study Adds This study shows that poor baseline visual acuity and concomitant lensectomy at the time of IOFB removal are independent predictors of poor final visual outcome. It also highlights the predominance of metal-related IOFBs, mostly caused by welding accidents, among young adult males. How this Study might Affect Research, Practice or Policy These findings emphasize the importance of early prognostication and patient counseling based on baseline vision and surgical planning. It also reinforces the need for occupational safety measures, particularly mandatory protective eyewear in high-risk jobs, and for strengthening early detection and referral systems in resource-limited settings. Keywords: ophthalmic trauma, intraocular foreign body, clinical characteristics, prognostic factors