New Innovative Approaches for Difficult Retained Intraocular Foreign Bodies.

PURPOSE: To describe innovative ways of removal of complicated difficult large retained intraocular foreign bodies (RIOFBs).

SETTINGS: Both cases were treated at Disha Eye Hospitals, Kolkata, a tertiary eye hospital in eastern India.

METHODS

Innovative approaches were taken to remove 2 difficult RIOFBs. In the first case, a large RIOFB was just beyond the posterior exit wound, trapped in the sclera. A 23-G MVR blade was used to create multiple radial releasing scleral nicks and bimanually moving the RIOFB into the vitreous cavity using a bent-tip 24G needle and magnet, and the RIOFB was removed through the limbal section. In the second case, a 21-mm long thick nail was deeply embedded in the superior sclera with partial localised retinal detachment with its bulbous end just behind the clear lens. A lasso technique was used to remove the RIOFB without lens touch.

RESULTS

In the first case, the patient finally achieved logMAR 0.2 vision after silicone oil removal and glued scleral fixation of the intraocular lens. In the second case, the patient finally achieved logMAR 0.3 vision after silicone oil removal and phacoemulsification with intraocular lens implantation.

CONCLUSION

Each case of RIOFB is unique and challenging. Here, innovative techniques are helpful to rescue these difficult RIOFB situations, which can result in excellent outcomes.