Removal of large subretinal foreign bodies with bimanual vitrectomy and use of a suture loop.

Abstract

To describe removal of large subretinal foreign bodies with bimanual pars plana vitrectomy and use of a suture loop. In a retrospective interventional case series, 2 eyes of 2 patients referred 1 month after primary wound suturation, both with posttraumatic retinal detachment and 1 with endophthalmitis, underwent pars plana vitrectomy. Intraocular foreign bodies (IOFBs) were grasped using a 6-0 polypropylene suture loop. The loop was placed around the IOFBs using an intraocular forceps, and the foreign bodies were extracted from the eyes. A suture loop was placed around the IOFB bimanually, and removal was performed as described. Two large subretinal IOFBs, one metallic and one nonmetallic, were removed successfully without slippage, the first through a limbal incision and the second through an enlarged sclerotomy. The patients were observed for 3 months. One eye had retinal attachment, but the other eye had redetachment that was considered inoperable. Large metallic and nonmetallic subretinal IOFBs of different shapes and sizes can be removed with a suture loop, but in complicated cases, bimanual placement of the loop may provide better control for IOFB removal and the ability to surround the IOFB at its desired axis, thereby decreasing the size of the incision for extraction.