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

Zhitao Su,Jijian Lin,Li Zhang,Panpan Ye,Xiaodan Huang

doi:10.1186/s12886-019-1065-6

Abstract

BackgroundTo explore minimal surgery in selected patients with intravitreal foreign body (IVFD) and traumatic cataract.MethodsTwelve 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.ResultsAll 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.ConclusionsPrimary 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.

Highlights

To explore minimal surgery in selected patients with intravitreal foreign body (IVFD) and traumatic cataract
To explore the possibility of minimal surgery in selected patients with small ferrous IVFD and traumatic cataract, here we report a series of cases with primary removal of IVFD by external magnetic extraction and
After confirming that there was no secondary glaucoma, endophthalmitis, or retinal injury and identification of the metallic-like foreign body suspended in the vitreous cavity, primary removal of IVFD was performed by direct external magnetic extraction

Summary

Introduction

To explore minimal surgery in selected patients with intravitreal foreign body (IVFD) and traumatic cataract. Ferrous intravitreal foreign body (IVFB), which did not damage the retina can be successfully removed by external magnetic extraction without PPV [7]. In the absence of increased intraocular pressure (IOP) or severe inflammatory reaction in traumatic cataract with posterior capsule rupture, delaying surgery would have allowed a more favorable intraocular lens (IOL) implantation in capsular bag with a better visual prognosis and lesser complications after control of inflammation and fibrosis of the capsule rupture [8]. To explore the possibility of minimal surgery in selected patients with small ferrous IVFD and traumatic cataract, here we report a series of cases with primary removal of IVFD by external magnetic extraction and

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Discussion

Conclusion