Intralenticular foreign body: A case report and literature review

Abstract

The purpose of this manuscript was to provide a better understanding of patients with intralenticular foreign bodies (FBs) and also to review the reported cases, including clinical presentation, diagnosis, management, and visual outcome. A 50-year-old male was referred to our clinic with suspected intraocular FB. Under slit-lamp examination, a full-thickness corneal wound with localized corneal edema at the temporal lower peri-limbal area was revealed. Seidel test did not indicate any wound leakage. The corresponding iris was depigmented, but there was no penetrating hole. The anterior chamber was deep with cells, but the lens, vitreous, and fundus were normal. B-scan ultrasonography and orbital computed tomography were performed, but no intraocular FB was detected. On the 2nd day, a zonal cortical cataract and posterior subcapsular cataract formed rapidly. Left-eye bare vision dramatically decreased from 20/100 to counting fingers. One month later, the patient received elective extracapsular cataract extraction. A fine metal thread was completely embedded in the lens; the lens and FB were removed together during the operation. The posterior capsule was not injured; an intraocular lens was implanted in the capsular bag. Two months postoperatively, left-eye vision had returned to 20/25. No adverse events were noted during the follow-up period. In addition to the case report, some 28 previously reported cases of intralenticular FB are reviewed here. Patient demographics, time and course of management, and visual outcome are all summarized and compared.

Lawn Trimmer–related Open-Globe Injuries in Taiwan

“…The intralenticular FB not being detected during the CT scan could be due to its smaller size compared with the 2.5-mm slice thickness of CT. Other studies also mention FBs being undetectable when they were embedded in the lens. [16][17][18][19] Similarly, these FBs were very small and were at times encapsulated, thus losing their magnetic properties or becoming radiolucent to x-rays. 17 As a result, ophthalmologists should always consider the possibility of intralenticular FBs and the potentially ruptured posterior capsule or the FB dropping into the PS intraoperatively.…”

Intralenticular foreign body: leave the quiet ones alone

“…1 Most of these foreign bodies are metallic and require lens extraction due to ocular inflammation, glaucoma or metallosis. 2 Glass and most plastic IOFBs tend to be inert, eliciting minimal or no inflammatory reaction. 3 Moreover, these Images in… materials are associated with lower endophthalmitis rates compared with vegetative matter and metallic objects.…”

Disappeared intralenticular foreign body: A case report

“…Conservative management of intralenticular foreign bodies has also been successful in other patients who have minimal lens opacities and stable visual function[ 3 , 4 ]. In most of these studies, the lens was either preserved without intraocular foreign body removal or removed together with intraocular foreign bodies[ 5 ].…”