International Consensuses and Guidelines on the Etiology, Diagnosis and Management of Intraocular Foreign Bodies (IOFBs) by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO), the Asia-Pacific Vitreo-retina Society (APVRS), and the Academia Retina Internationalis (ARI).

PURPOSE: To discuss the critical aspects and establish a consensus among experts regarding intraocular foreign bodies (IOFB) management, and to standardize clinical management for IOFB cases in order to ensure consistent and optimal clinical outcomes.

DESIGN

A modified Delphi method to reach a consensus among international experts.

METHODS

An expert panel was formed by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO), the Asia-Pacific Vitreo-retina Society (APVRS), and the Academia Retina Internationalis (ARI) to identify the controversy and establish consensus and statement on the management of IOFB. The core group of the panel gathered, reviewed, discussed, and formulated the statements. The statements were rated by the expert panel based on a five-point Likert scale (strongly agree, agree, neutral, disagree and strongly disagree). A consensus was reached when at least 75% of the experts voted either "agree" or "strongly agree" for a statement.

RESULTS

Twenty four international experts from 11 countries/territories participated. Fifty four consensus statements were reviewed in the following 8 sections: diagnostic controversies, ⁠⁠IOFB characterization controversies, management controversies, prophylactic measures controversies, post-extraction management controversies, special population considerations, outcomes assessment controversies, and future directions. The expert panel showed good agreement in all sections. Consensus was reached for 49 out of 54 statements, while the final score was less than 75% for 5 statements.

CONCLUSION

The strong majority of consensus statements serves as a useful guidance, enabling clinicians to approach IOFB removal in a systemic manner with more confidence and improve patient outcomes. The varying levels of agreement in some statements underscore remaining uncertainties in IOFB clinical management.