scholarly journals Combined Cataract Extraction With Pars Plana Vitrectomy and Metallic Intraocular Foreign Body Removal Through Sclerocorneal Tunnel Using a Novel “Magnet Handshake” Technique

2020 ◽  
Vol 76 (1) ◽  
pp. 14-23
Author(s):  
Štěpán Rusňák ◽  
Lenka Hecová

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.


2015 ◽  
Vol 8 (4) ◽  
pp. 24-29 ◽  
Author(s):  
Vadim Petrovich Nikolaenko ◽  
Mariya Valerievna Kataeva

Objective: to evaluate early and remote complication of intraocular foreign body (FB) removal by direct approach, and to determine indications for splinter removal through the wound. Material and methods. Case history analysis was performed in 31 patients with missile eye injuries. In all patients, FB was removed by direct approach at initial surgical debridement. Results. Foreign body penetration was accompanied with injuries of different eye segments, which were manifested by vitreous hemorrhage, hyphema, subretinal hemorrhage, retinal detachment, traumatic cataract. In 12 patients, there was a need in additional surgical treatment consisting in retinal laser barrage, vitrectomy, cataract extraction. As a result of treatment, visual acuity increased in 58.06% of injured. At the remote post-op period, retinal detachment developed in 16.13% cases, and vitreoretinal procedures were performed. Conclusions. Intraocular foreign body removal from the posterior eye segment using direct approach is appropriate if the FB is in the wound or in its immediate proximity. Most serious complications of missile injury are proliferative vitreoretinopathy and retinal detachment, demanding vitreoretinal surgery.


2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Robert Rejdak ◽  
Tomasz Choragiewicz ◽  
Joanna Moneta-Wielgos ◽  
Dominika Wrzesinska ◽  
Dorota Borowicz ◽  
...  

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.


2020 ◽  
Vol 58 (226) ◽  
Author(s):  
Lily Rajbanshi ◽  
Archana Kumari ◽  
Sanjay Singh

Firecracker induced open globe injury is a big challenge for ophthalmic surgeons. Its associationwith the intraocular foreign body makes the diagnosis and treatment even more difficult resultingin poor anatomical and visual outcomes. We report a case of a 35-year-old male who presented withbilateral, multiple corneal and intraocular foreign body due to firecracker explosion. His vision waslimited to hand movement in both eyes. Combined penetrating keratoplasty and cataract surgerywere done in both eyes followed by pars plana vitrectomy for intraocular foreign body removal.The final best-corrected visual acuity of the patient stood to be 6/6 and 6/9 in the right and left eyerespectively. The encouraging result in our case prompts ophthalmologists for a timely stepwisemultidisciplinary approach in all open globe injuries with intraocular foreign body cases havingpoor initial acuity.


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