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Introduction:

Ocular trauma associated with intraocular foreign bodies (IOFBs) is one of the major causes of visual impairment in young individuals. Various reports indicate that 18-41% of all open globe injuries involve at least one IOFB. IOFBs may become embedded in the retina posing a challenging situation for vitreoretinal surgeons. In addition to the general complications of IOFBs, intraretinal foreign bodies (IRFBs) specifically increase the risk of retinal breaks and detachments, choroidal hemorrhage, subretinal fibrosis and macular pucker. Despite improvements in surgical instrumentation and techniques, the rate of complications related to removal of IRFBs remains high.

Purpose:

Documenting a case of an IRFB in order to show the best therapeutic approach in the authors´s experience.

Material and Methods:

Male patient, 62 years, subjected to extraction of steel intraocular foreign body. The patient was admitted to the Emergency Room University of Coimbra‘s Hospital Center with complaints of sudden vision loss and pain after having been working with a trimmer. The clinical examination showed a corneal wound, and a dense cataract. A CT scan was performed revealing an IRFB. The therapeutic approach was surgical, using phacoemulsification, 23G pars plana vitrectomy, removal of the posterior hyaloid, extraction of the IRFB with endoelectroiman and artisan implantation forceps through the cornea, 360º endolaser, placing the lens in the ciliary sulcus, fluid/air exchange and corneoescleral suture.

Results:

The patient had a favorable outcome with improvement in visual acuity and maintaining the integrity of the eyeball.

Conclusion:

According to the authors‘s experience, in patients with large and irregular IOFBs, the most effective and safer surgical approach consist in the use of electric endomagnet and artisan implantation forceps in a ”handshake technique“.


Bibliography:

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2) Successful Removal of Large Intraocular Foreign Body by 25-Gauge Microincision Vitrectomy Surgery. Hiroshi Kunikata, Megumi Uematsu, Toru Nakazawa, Nobuo Fuse. J Ophthalmol. 2011; 2011: 940323. Published online 2011 April 4. doi: 10.1155/2011/940323

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