Posterior Segment Intraocular Foreign Body: Extraction Surgical Techniques, Timing, and Indications for Vitrectomy

Guevara-Villarreal, Dante A; Rodríguez‐Valdés, Patricio J.

doi:10.1155/2016/2034509

Cited by 19 publications

(16 citation statements)

References 22 publications

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“… 6 Early treatment can also be beneficial to control inflammation and decrease the rate of proliferative vitreoretinopathy, although it might not be associated to significantly larger improvement in visual acuity. 7 …”

Section: Discussionmentioning

confidence: 99%

Conservative management of penetrating ocular trauma caused by a nail gun

Carral-Santander

Acón-Ramírez

Soberon

et al. 2018

American Journal of Ophthalmology Case Reports

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PurposeTo report the conservative management of a penetrating ocular trauma caused by a nail gun with a six-month follow up.ObservationsA 21 year-old healthy female suffered an ocular penetrating trauma with a nail gun. She presented with a metallic foreign body that partially entered her left eye through the nasal sclera via pars plana, 3 mm posterior to the limbus, but did not reach the retina. Surgical removal of the foreign body and closure of the scleral wound, without vitrectomy, was performed 16 h after the injury. Intravitreal prophylactic antibiotic was administered. Retinal atrophy developed in the areas that had commotio retinae at presentation, but no further complications were observed.Conclusions and importancePars plana vitrectomy may not be necessary in all penetrating ocular traumas with intraocular foreign body, as long as the foreign body is accessible from the exterior of the eye and there are no other conditions (such as vitreous hemorrhage, retinal detachment, endophthalmitis, etc) that are an indication for vitrectomy.

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Section: Discussionmentioning

confidence: 99%

Conservative management of penetrating ocular trauma caused by a nail gun

Carral-Santander

Acón-Ramírez

Soberon

et al. 2018

American Journal of Ophthalmology Case Reports

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“…Then, the IOFB is extracted using an EEM and an indirect ophthalmoscope. Finally, the sclera is sutured, and cryopexy is performed [ 124 ]. Nevertheless, the alignment of the magnetic tip, the surgical incision and the IOFB are very challenging, and IOFB removal is not under the surgeon’s visual control [ 42 ].…”

Section: Treatmentmentioning

confidence: 99%

“…Thus, IOFBs may lacerate the retina or anterior ocular structures such as the lens, zonules or ciliary body when it is rapidly pulled towards the tip of the magnet. In particular, IOFB removal with EEM is associated with a 23% risk of developing vitreous haemorrhage and 10% risk of developing endophthalmitis [ 124 , 125 ]. EEM also tends to overheat and eventually burn the patient’s skin [ 126 , 127 ].…”

Section: Treatmentmentioning

confidence: 99%

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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“…K úrazům dochází obvykle v zaměstnání (54 -72 %), popř. v domácnosti (30 %) [6]. Mechanismus úrazu je nejčastěji úder kovu na kov (60 -80 %) [6].…”

Section: úVodunclassified

“…Obrázek 1Metalické nitrooční těleso lze ze zadního segmentu oka odstranit několika způsoby -transsklerální extrakcí exomagnetem nebo extrakcí endomagnetem s částečnou či kompletní PPV. Vzhledem k riziku rozvoje závažných pooperačních komplikací (především riziko vitreoretinální trakce s možným rozvojem trakční amoce sítnice a riziko endoftalmitidy) [6,12] v případě transsklerální extrakce, popř. extrakce endomagetem s parciální PPV je v současnosti preferována metoda extrakce endomagnetem s úplnou PPV.…”

Section: úVodunclassified

Untitled

Rušňák

Hecová

2020

CSO

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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.

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Posterior Segment Intraocular Foreign Body: Extraction Surgical Techniques, Timing, and Indications for Vitrectomy

Cited by 19 publications

References 22 publications

Conservative management of penetrating ocular trauma caused by a nail gun

Conservative management of penetrating ocular trauma caused by a nail gun

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

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