To investigate the outcome of surgery for a metallic intraocular foreign body and prognostic factors for visual acuity.

A retrospective chart review was performed on 47 eyes of 47 patients who underwent surgical removal of a metallic intraocular foreign body (IOFB) after eyeball laceration between 2000 and 2010. We investigated the location and size of eyeball lacerations, the location of IOFB, the clinical findings at initial examination, surgical methods and best corrected visual acuity. We analyzed the prognostic factors for final visual acuity.

The mean age was 45 years, and the most common cause of IOFB was lawnmower use. Cornea (77%) was the most frequently involved structure, and hyphema (72%) was the most common finding at initial slit lamp examination. Retina was the most common site of IOFB. The average visual acuity was 0.17 ± 0.49 before surgery, and the final visual acuity was 0.23 ± 0.39. Good visual prognosis was observed when the initial visual acuity was good or when the IOFB was located in the anterior segment, but the prognosis was poor when there was a vitreous opacity compromised with endophthalmitis at initial examination.

An IOFB should be removed as soon as possible. Good initial visual acuity and anterior segment IOFB are good prognostic factors of visual outcome.