scholarly journals Intraocular foreign body removal: Case report

2013 ◽  
Vol 141 (1-2) ◽  
pp. 81-84 ◽  
Author(s):  
Igor Kovacevic ◽  
Aleksandar Gakovic ◽  
Ivan Stefanovic ◽  
Smiljka Djuric ◽  
Sofija Davidovic ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Posterior Part ◽  
Vitreous Body ◽  
Corneal Edema ◽  
Intraocular Foreign Body ◽  
Foreign Body Removal ◽  
Normal Limits ◽  
Entry Wound ◽  
Pars Plana

Introduction. An intraocular foreign body may traumatize the eye mechanically, introduce infection or exert other toxic effects on the intraocular structures. Removal of a metallic intraocular foreign bodies (IOFB) use an internal (vitrectomy followed by forceps or internal magnet use) or external approach (large electromagnet). Outline of Cases. A 51-year-old man sustained injury of the left eye by a metal foreign body. On admission visual acuity was normal (VOS=1.0) and intraocular tension was within normal limits (TOS=10 mmHg). Nasal scleral entry wound was noticed. Ultrasound of the left eye was done, which confirmed existence of IOFB laying nasally, next to the ciliary body. Extraction of IOFB with a big electric magnet was done. Visual acuity on discharge was the same (VOS=1.0). Another man, aged 30 years, came to the clinic after injury of the left eye by a foreign body. On admission visual acuity was VOS=L+P+ (light and projection), TOS=44 mmHg (higher), traumatic cataract, scleral entry wound, corneal edema, existence of IOFB and initial endophtalmitis. Lensectomia and vitrectomia via pars plana with IOFB extraction were done. Visual acuity on discharge was VOS=5/60 with +6.50 Dsph = 0.3-0.4; TOS=17 mmHg. Conclusion. Magnet removal is indicated in patients when IOFB is laying free in the vitreous body or stopped near the entry wound during injury without other complications. Internal approach - pars plana vitrectomy with forceps removal is used when IOFB is stuck either on the peripheral or posterior part of the retina or if there are some of aforementioned complications.

scholarly journals Pars plana vitrectomy with extraction of intraocular foreign body in patients with siderosis of the eye: Report of two cases

2013 ◽  
Vol 141 (5-6) ◽  
pp. 371-374
Author(s):  
Igor Kovacevic ◽  
Ivan Stefanovic ◽  
Milos Jovanovic ◽  
Jelena Potic ◽  
Goran Damjanovic
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Pars Plana Vitrectomy ◽  
Intraocular Foreign Body ◽  
Penetrating Injuries ◽  
Entry Wound ◽  
Pars Plana ◽  
The Right ◽  
Metal Foreign Body

Introduction. Penetrating injury is characterized by the existence of entry wound only, and it can be with or without an intraocular foreign body (IOFB). IOFB can lead to a mechanical injury of the eye and to cause infection or to manifest other toxic effects on intraocular structures. Iron and copper can dissolve and cause siderosis, i.e. chalcosis of the eye. Ocular siderosis is diagnosed by clinical and electroretinogram (ERG) findings. Outline of Cases. The first patient was a 37?year?old male who was injured by a metal foreign body. He presented at the Clinic two years after the injury. Visual acuity of the right eye (VOD) on admission was VOD=L+P+ (light projection). Pars plana phacovitrectomy with IOFB extraction was done. Visual acuity on discharge was VOD=3/60 cc + 7.50 Dsph=0.2. The second patient was a 55?year?old male who presented at the clinic 18 months after injury. On admission visual acuity in his left eye was VOS 1/60. Pars plana phacovitrectomy with IOFB extraction was done. Visual acuity on discharge was VOS=0.7 through the stenopeic slit. Conclusion. In penetrating injuries caused by a metal IOFB pars plana vitrectomy with IOFB extraction is indicated. In cases with IOFB, when visual acuity is preserved, the lens is transparent, while the eye is without signs of infection, urgent pars plana vitrectomy is not necessary. Such patients need regular follow?up with obligatory ERG findings.

Transscleral Extraction of an Intraocular Foreign Body From the Posterior Segment of the Eye Without Pars Plana Vitrectomy

2020 ◽  
Vol 76 (1) ◽  
pp. 14-23
Author(s):  
Štěpán Rusňák ◽  
Lenka Hecová
Keyword(s):  
Foreign Body ◽  
Pars Plana Vitrectomy ◽  
Young Patients ◽  
Vitreous Body ◽  
Visual Control ◽  
Intraocular Foreign Body ◽  
Survey Study ◽  
Surgical Method ◽  
Eye Trauma ◽  
Pars Plana

Purpose: Penetrating eye trauma with an intraocular foreign body is very frequent, especially in men in their productive age. Pars plana vitrectomy would be the standard surgical method at our department. However, in indicated cases (metallic intraocular bodies in the posterior eye segment in young patients with well transparent ocular media without detached ZSM and without any evident vitreoretinal traction) transscleral extraction of the intraocular foreign body is performed using the exo magnet, eventually endo magnet with a minimal PPV without PVD induction under the visual control of endo-illumination. Materials and Methods: Between June 2003 and June 2018, 66 eyes of 66 patients diagnosed with a penetrating eye trauma caused by an intraocular foreign body located in the posterior eye segment were treated. In 18 eyes (27,3 %) with a metallic foreign body in vitreous (body) or in retina, no PPV or a minimal PPV without PVD was used as a surgical method. In the remaining 48 eyes (72,7 %), a standard 20G, respectively 23G PPV method were used together with PVD induction and the foreign body extraction via endo or exo magnet. Conclusions: As demonstrated by our survey/study, in the cases of a thoroughly considered indication an experimented vitreoretinal surgeon can perform a safe NCT transscleral extraction from the posterior eye segment via exo magnet, eventually endo magnet under the visual control of a contact display system with a minimal PPV. Thereby, the surgeon can enhance the patient´s chance to preserve their own lens and its accommodative abilities as well as reduce the risk of further surgical interventions of the afflicted eye.

scholarly journals Intraoperative Macula Protection by Perfluorocarbon Liquid for the Metallic Intraocular Foreign Body Removal during 23-Gauge Vitrectomy

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Robert Rejdak ◽  
Tomasz Choragiewicz ◽  
Joanna Moneta-Wielgos ◽  
Dominika Wrzesinska ◽  
Dorota Borowicz ◽  
...  
Keyword(s):  
Foreign Body ◽  
Intraocular Foreign Body ◽  
Perfluorocarbon Liquid ◽  
Foreign Body Removal ◽  
Corrected Distance Visual Acuity ◽  
Iatrogenic Lesion ◽  
Pars Plana ◽  
The Mean ◽  
23 Gauge

Purpose.To evaluate visual and safety outcomes of 23-gauge (G) pars plana vitrectomy (PPV) with application of perfluorocarbon liquid (PFCL) for intraoperative protection of the macula during intraocular foreign body (IOFB) removal.Methods.Retrospective study of 42 patients who underwent 23 G PPV for IOFB removal from posterior segment with intraoperative PFCL application for the macula shielding. Collected data included corrected distance visual acuity (CDVA), size of IOFB, and complication rate. The mean follow-up period was 12 months.Results. The mean preoperative CDVA was 0.54 logMAR (SD 0.46), and the final mean CDVA was 0.68 logMAR (SD 0.66). All IOFBs were metallic with mean dimensions of 4.6 mm × 2.1 mm. Twenty-two IOFBs were removed through the corneal tunnel and 20 IOFBs through the sclerotomy. No intraoperative iatrogenic lesion of the macula was observed. As a tamponade, silicon oil was applied in 31 eyes, SF6gas in 5 eyes, air in 4 eyes, and 2 eyes required no tamponade. Secondary retinal detachment was observed in 17% of cases, but at the end of the follow-up, all the retinas were attached.Conclusion. PFCL application during PPV is a safe method of protecting the macula from unexpected falling of the metallic IOFB during its removal.

scholarly journals Big intraocular foreign body: Case report

2013 ◽  
Vol 141 (7-8) ◽  
pp. 516-518
Author(s):  
Aleksandar Gakovic ◽  
Igor Kovacevic ◽  
Jovana Bisevac ◽  
Bojana Radovic ◽  
Katarina Cubrilo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Retinal Detachment ◽  
Detailed Examination ◽  
Posterior Segment ◽  
Intraocular Foreign Body ◽  
Traumatic Cataract ◽  
Normal Limits ◽  
The Right ◽  
Fitting In

Introduction. Penetrated injuries are most difficult injuries of the eye. Intraocular foreign body (IOFB) may lodge in any of the structures it encounters, from anterior chamber to the retina and choroid. Notable effects caused by foreign body injury include traumatic cataract, vitreous liquefaction, retinal and subretinal hemorrhages, retinal detachment and development of endophtalmitis. Case Outline. A 49?year?old man sustained injury of the right eye with a piece of metal wire. On admission visual acuity was VOD: 1.0 and lower intraocular tension TOD=6 mmHg (10?22 mmHg). Corneal entry wound was noticed near limb on 11h with a prominating foreign body of 18 mm in length that passed through the iris, lens and vitreous. X?ray findings confirmed existence of a large foreign body extending along the entire length of the globe. IOFB removal was done with anatomic forceps. On postoperative detailed clinical examination we observed retinal rupture in the upper temporal quadrant fitting in the area of the IOFB damaged retina. Laser photocoagulation of retinal tear (laser retinal barrage) was done. Visual acuity on discharge was the same (1.0) and intraocular tension was within normal limits (10 mmHg). Conclusion. Penetrated injury of eye requires detailed examination of all eye structures, beginning from the anterior to posterior segment. Timely diagnosed ruptures of the posterior segment of eye before the development of traumatic cataract, and adequate therapeutic procedures prevent serious complications of IOFB penetrated eye injury such as retinal detachment and permanent reduction of visual acuity.

scholarly journals Posterior Segment Retained Intraocular Foreign Body: A Study from Western Nepal

2021 ◽  
Vol 13 (1) ◽  
pp. 22-30
Author(s):  
Bikram Bahadur Thapa ◽  
Sweta Singh ◽  
Gyanendra Lamichhane ◽  
Shanti Gurung ◽  
Saurav Piya
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Large Diameter ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Intraocular Foreign Body ◽  
Pars Plana ◽  
The Mean

Introduction: Posterior segment retained Intraocular foreign body (IOFB) management is challenging. Facility of pars plana vitrectomy (PPV) and availability of well trained vitreo retina surgeons are the basic need to accomplish this work.  Encircling band provide permanent 360° support to close the anterior retinal break and prevent traction on the retina. The objective of this study is to analyse the clinical characteristics and predictors of the final visual outcome and survival of the globe in cases of retained IOFB in the posterior eye segment. Materials and methods: A hospital based retrospective observational study was conducted. All the patients of retained IOFB in the posterior segment presented from January 2016 to June 2019 were enrolled. Patients presented with visual acuity of NPL were excluded. Statistical analysis was performed using a variety of tests using SPSS version 21.   Results: Forty eyes of 40 patients were included. The mean age was 27.08±10.68 years (range 5-66). 95% of our patients were male. Most of them (52.5%) worked on the farm. 26(65%) of 40 eyes had Zone I injury. The median time spent before presentation was 13.5 day. Retinal detachment, vitreous hemorrhage, and endophthalmitis were present in 15, 23 and 5 eyes, respectively, before IOFB removal. The mean LogMAR visual acuity was improved significantly from 2.50±0.87 to 1.33± 1.01 (p=0.003). Poor presenting visual acuity, retinal detachment and large diameter of IOFB were found as the predictor of poor final visual acuity. Conclusion:  Pars plana vitrectomy by a vitreo retinal surgeon can give encouraging results in the cases of retained posterior segment IOFB. Poor presenting visual acuity, large diameter of IOFB and RD before IOFB removal are predictors of poor visual outcome.

scholarly journals Overlooked retained intraocular foreign body

2015 ◽  
Vol 72 (5) ◽  
pp. 463-465 ◽  
Author(s):  
Antoaneta Adzic-Zecevic ◽  
Edita Files-Bradaric ◽  
Mirjana Petrovic
Keyword(s):  
Visual Acuity ◽  
World War Ii ◽  
Foreign Body ◽  
Vitreous Body ◽  
Body Cavity ◽  
Intraocular Foreign Body ◽  
Temporal Region ◽  
Trauma Case ◽  
Eye Damage ◽  
Type Of Injury

Introduction. The most common cause for litigation against ophthalmologists in a trauma case is a missed intraocular foreign body (IOFB). IOFBs cause internal eye damage, but some will come to rest in the posterior segment of the eye. Case report. We presented a 57-year-old male who was referred to the ophthalmologist due to decreased visual acuity in his left eye. Slit lamp examination of his left eye showed no pathological findings. Goldmann contact lens examination showed IOFB which was lying in the vitreous body in the inferior-temporal region. Retinal rupture was noticed at 7 o?clock. The optical coherence tomography (OCT) examination was performed and it showed atrophic macular area as well as decreased peripapillar retinal fiber layers thickness. Ultrasound showed the IOFB in vitreous body cavity. History revealed that the patient had an accidental trauma, 48 years ago, when an old bomb from World War II (WWII) exploded. Due to the decrease in visual acuity and fibrosis of the vitreous body surgical intervention was performed on his left eye (phacoemulsification with intraocular lens implantation, pars plana vitrectomy and instrumental extraction of foreign body). Conclusion. The intraocular foreign body (IOFB) was asymptomatic for 48 years. Symptoms depend on material and localization of the foreign body and the type of injury.

Low-cut, low-vacuum vitrectomy for releasing an embedded intraocular foreign body

Trauma ◽  
2020 ◽  
pp. 146040862093576
Author(s):  
SK Aruna ◽  
Pratyusha Ganne ◽  
Prabu Baskaran
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Retinal Detachment ◽  
Intraocular Foreign Body ◽  
Corrected Visual Acuity ◽  
Open Globe ◽  
Pars Plana ◽  
Oil Injection ◽  
Probe Set ◽  
Best Corrected Visual Acuity

Background Removal of an embedded intraocular foreign body remains challenging due to the risks of bleeding and retinal damage. We present a novel technique to deal with this situation. Case report A 32-year man presented with two months of decreased vision in one eye (best corrected visual acuity of 20/200), a year after a workplace injury that necessitated surgery for an open globe injury. Examination revealed the sequalae of his previous surgery, a subtotal retinal detachment and an embedded intraocular foreign body close to inferior ora serrata at the 6 'o clock position confirmed by imaging. The other eye was normal. A pars plana vitrectomy was performed and the embedded intraocular foreign body was released from surrounding dense adhesions using the vitrectomy probe set at 1000 cuts/minute and 100 mm Hg vacuum, followed by fluid air exchange and endolaser with silicon oil injection. The retinal detachment settled well post-operatively, and at the end of one month, the patient had best corrected visual acuity of 20/60. Conclusions The low-cut, low-vacuum vitrectomy technique can be considered as a safe option for releasing the embedded intraocular foreign body in complex ocular trauma scenarios.

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