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

Dhoble, Pankaja; Khodifad, Ashish

doi:10.22608/apo.2017207

Cited by 10 publications

(8 citation statements)

References 25 publications

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“…The prognosis of traumatic eye injuries associated with IOFB and traumatic cataract varies greatly depending on a number of factors, which include the time between trauma and IOFB extraction, initial visual acuity, entrance wound location, nature of IOFB, location of IOFB, preoperative retinal detachment, presence of intraocular hemorrhage, presence of endophthalmitis, primary surgical repair combined with IOFB removal and the occurrence of postoperative complications. Combined phacoemulsification, vitrectomy, foreign-body extraction, and IOL implantation have become more and more popular in the management of such patients [1, 10–12]. However, small ferrous IVFD can be successfully removed by external magnetic extraction through the pars plana incision in patients without endophthalmitis and retinal injury [7].…”

Section: Discussionmentioning

confidence: 99%

“…Among patients with posterior segment intraocular foreign body (IOFB) and traumatic cataract, visual rehabilitation poses a unique challenge to ophthalmic surgeons. With the development of surgical techniques and instruments, there is an increasing trend toward performing pars plana vitrectomy (PPV) and simultaneous cataract extraction in the management of these patients [1–3]. However, various potential complications of PPV have been reported [4–6].…”

Section: Introductionmentioning

confidence: 99%

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Minimal surgery achieved good visual acuity in selected patients with magnetic intravitreal foreign body and traumatic cataract

Lin

et al. 2019

BMC Ophthalmol

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Background To explore minimal surgery in selected patients with intravitreal foreign body (IVFD) and traumatic cataract. Methods Twelve eyes of 12 patients with small ferrous IVFD and traumatic cataract without endophthalmitis, retinal injury and secondary glaucoma, between September 2015 and March 2017 were retrospectively analyzed. Primary removal of IVFD was performed by external magnetic extraction through the pars plana incision. Secondary removal of traumatic cataract by phacoemulsification and intraocular lens (IOL) implantation with or without anterior vitrectomy were performed. Patients were followed up at 1 day, 1 week, 1 month, 3 months, 6 months and 12 months after surgery. Results All patients were male with a mean age of 32 years old. All IVFDs were successfully removed without retinal injury. Two to 6 months later, the traumatic cataract was successfully removed by phacoemulsification combined with IOL implantation in the capsule bag in 10 patients. Anterior vitrectomy was implied in 2 patients with large posterior capsule rupture, and the IOLs were placed in the ciliary sulcus. Best-corrected visual acuity ranged from hand movement to 20/100 before surgery and improved ranging from 20/32 to 20/20 at the final follow-up. The IOLs were well centered. Complications such as secondary glaucoma, endophthalmitis and retinal detachment were not found. Conclusions Primary removal of small ferrous IVFD by external magnetic extraction followed by secondary cataract removal and IOL implantation is an appropriate choice. Minimal surgery may obtain good visual outcome without complications in selected patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minimal surgery achieved good visual acuity in selected patients with magnetic intravitreal foreign body and traumatic cataract

Lin

et al. 2019

BMC Ophthalmol

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“…The second IOM is fundamental to hold and deliver the IOFB safely outside. This technique is suitable for IOFBs with irregular shapes or diameters greater than 5 mm [128]. In a series of ten patients in which the abovementioned technique was applied, the final VA was 20/60 or better in seven of them, between 20/200 and 20/80 in one and counting fingers or less in two [128].…”

Section: Surgery Techniquesmentioning

confidence: 97%

“…The internal approach for removing IOFBs is performed using forceps or intraocular magnets (IOMs). Several surgical forceps are available: engulfing the IOFB or with serrated jaws to capture irregularly shaped IOFBs [128,129]. Instead, IOM requires less surgical skill but can remove free-flying IOFBs less than 2 mm in diameter [42].…”

Section: Surgery Techniquesmentioning

confidence: 99%

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Ocular siderosis: a misdiagnosed cause of visual loss due to ferrous intraocular foreign bodies—epidemiology, pathogenesis, clinical signs, imaging and available treatment options

et al. 2020

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Purpose The purpose of this paper is to provide a meaningful literature review about the epidemiology, pathogenesis, clinical signs, imaging and treatment of ocular siderosis (OS). Methods A computerized search from inception up to March 2020 of the online electronic database PubMed was performed using the following search strings: “ocular siderosis” and “siderosis bulbi”. The reference list in each article was analysed for additional relevant publications. Results OS is an uncommon cause of visual loss due to a retained ferrous intraocular foreign body (IOFB). It may develop from 18 days to years after a penetrating trauma that usually occurs during hammering. On average, patients are 22–25 years old, and the vast majority are male. The most common cause of OS development is delayed presentation by the patient or missed diagnosis of IOFB after trauma. The pathophysiology is not fully understood; nevertheless, iron deposition causes hydroxyl radical formation, which damages photoreceptors and retinal pigment epithelium. Moreover, iron damages retinal vessels with consequent inner retinal layers degeneration. The most frequent signs are iris heterochromia, pupillary mydriasis, cataract development and retinal arteriolar narrowing with pigmentary retinal degeneration. Electroretinogram signs, in particular, b-wave amplitude reduction, arise earlier than clinical signs. Orbital CT scans and ultrasonography play an essential role in detecting IOFBs. Treatment depends on the IOFB location and OS development. However, it is crucial to remove the IOFB after OS development because visual acuity and clinical signs may improve. Anterior segment IOFBs can be dislodged using an intraocular magnet (IOM) or forceps through limbal paracentesis. In contrast, posterior segment IOFBs require a pars plana vitrectomy and IOM or forceps to be removed through an enlarged sclerotomy or the limbus. Conclusion Recommending the usage of protective glasses and spreading knowledge about OS may further benefit patient care.

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Intraocular Foreign Bodies: Clinical Characteristics and Prognostic Factors Influencing Visual Outcome and Globe Survival in 373 Eyes

Liu

Wang

Liu

et al. 2019

Journal of Ophthalmology

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Aim. To describe epidemiologic and clinical characteristics and prognostic factors influencing visual outcome after intraocular foreign bodies (IOFBs) injury. Methods. Medical records of 370 patients (373 eyes) with IOFBs were reviewed to identify the factors influencing visual acuity by univariate and multivariate analyses. Results. The majority of patients (97.0%) were men, with a mean age of 38.1 years. The most common cause of ocular injury was hammering (52.6%); magnetic IOFBs occurred in 84.7% of these cases. Factors associated with poor visual outcome (defined as <1.3 logMAR) included the following: age ≥50 years (P=0.046); worse presenting visual acuity (P<0.001); complications of retinal breaks (P=0.006) and endophthalmitis (P=0.032); vitrectomy (P=0.035); and intraocular C3F8 gas tamponade (P=0.038). Excellent visual outcome (defined as ≥0.5 logMAR) was associated with age <50 years (P=0.003); better presenting visual acuity (PVA) (P<0.001); wound length <4 mm (P=0.005); absence of vitreous hemorrhage (P=0.026) and retinal breaks (P<0.001); nonvitrectomy surgery (P=0.043); and use of balanced saline (P=0.029). Conclusions. Multiple prognostic factors were identified that may predict visual outcome and globe survival after IOFBs injury. Age, initial presenting visual acuity, wound length, complications (vitreous hemorrhage, retinal breaks, and endophthalmitis), surgical approach, and intraocular tamponade were significant predictors of visual outcome.

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

Abstract: Combined cataract extraction with PPV and metallic IOFB removal through sclerocorneal tunnel using the "magnet handshake" technique gives good visual and surgical outcomes.

Cited by 10 publications

References 25 publications

Minimal surgery achieved good visual acuity in selected patients with magnetic intravitreal foreign body and traumatic cataract

Minimal surgery achieved good visual acuity in selected patients with magnetic intravitreal foreign body and traumatic cataract

Ocular siderosis: a misdiagnosed cause of visual loss due to ferrous intraocular foreign bodies—epidemiology, pathogenesis, clinical signs, imaging and available treatment options

Intraocular Foreign Bodies: Clinical Characteristics and Prognostic Factors Influencing Visual Outcome and Globe Survival in 373 Eyes

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