Metallic Intraocular Foreign Body Research Articles

Management of intraretinal Metallic Foreign Bodies without Retinopexy in the Absence of Retinal Detachment

In the management of intraocular metallic foreign bodies impacting or embedded in the posterior retina but without retinal detachment, retinopexy can be difficult or dangerous because of surrounding retinal, subretinal, or choroidal hemorrhage, or the proximity of the foreign body to the optic disc and macula. The authors prospectively managed five such cases by pars plana vitrectomy and foreign body removal without intraoperative or postoperative retinopexy. Fluid gas exchange was performed in only one case. No attempt was made to create a posterior vitreous detachment in any of the cases. After follow-up, ranging between 8 and 35 months, all cases had attached retinas and chorioretinal adhesion around the foreign body site. None of the cases had preretinal macular fibrosis. Four of the five cases had a best corrected visual acuity of 20/20 or better. The other, an aphakic 3-year-old patient, was amblyopic. Spontaneous chorioretinal adhesion appears to obviate the need for retinopexy in these selected cases. The avoidance of retinopexy and fluid gas exchange may decrease the risk of retinal detachment and preretinal macular fibrosis.

Longitudinal electroretinogram study in a patient with metallosis oculi

Serial electroretinograms were obtained from a patient with visual loss secondary to an intraocular metallic foreign body. Six days after the injury, the acute-phase electroretinogram was larger in the affected left eye. During the following months, the electroretinogram amplitude declined steadily in the affected eye to values well below normal. At 9 months, electroretinogram amplitudes were approximately 50% compared with those in the normal eye. Clinical signs confirmed the need for surgery, and the foreign body was removed. Visual acuity in both eyes remained essentially normal, and electroretinogram amplitudes stabilized over subsequent months. Approximately 8 months after surgery, dark-adaptometry testing showed a 1-log unit elevation of absolute threshold in the affected eye, and Rmax in the affected eye was 42% of that in the uninjured eye.

Combined Phacoemulsification and Pars Plana Vitrectomy

Combined phacoemulsification and pars plana vitrectomy were performed in eight eyes with cataract and vitreoretinal disease. Six eyes had tractional retinal detachment and/or nonclearing vitreous hemorrhage, one eye had a retained metallic intraocular foreign body, and one eye had a traumatic retinal detachment. In six eyes, a posterior chamber lens implant was placed in the capsular bag. Postoperative visual acuity improved in each case and ranged between 20/15 and 6/200. There were no perioperative complications, and the posterior chamber lens implant appeared well tolerated during an average follow-up interval of 8 months (range, 3 to 30 months). This technique allows endocapsular fixation of a posterior chamber lens and provides rapid visual rehabilitation with a single operation.

Detection and localization of nonmetallic intraocular foreign bodies by magnetic resonance imaging.

Computed tomography (CT) is useful in detecting metallic intraocular foreign bodies. Magnetic resonance imaging (MRI) is a technique that might allow the detection and localization of nonmetallic intraocular foreign bodies. We performed CT and MRI scans on ten freshly enucleated sheep eyes, eight of which contained nonmetallic intraocular foreign bodies of wood, glass, plastic, or rock. Computed tomography correctly detected seven of eight foreign bodies, while MRI detected all eight of the foreign bodies. Computed tomography is necessary to determine the presence of a metallic foreign body, but when the CT scan is negative, MRI may still detect small nonmetallic foreign bodies.

Subretinal Neovascularization

<h3>To the Editor.</h3> —In their interesting article "Subretinal Neovascularization Following Metallic Intraocular Foreign Body Trauma," in the April 1986Archives, Trimble and Schatz¹state that "subretinal neovascularization as a complication of chorioretinal injury from a metallic intraocular foreign body, to our knowledge, has not previously been reported." It may be of interest to them that I reported, in<i>The Blood-Retinal Barriers</i>,²a case of a patient in whom subretinal neovascularization developed at the impact site after a direct hit on the paramacular retina by a copper wire. The wire struck the macula just superonasal to the fovea, after which it fell into the vitreous. I suggested that this appeared to be a model for the development of subretinal new vessels in humans. I agree that the metal wire makes a break in the retina, retinal pigment epithelium, Bruch's membrane, and, possibly, the choricapillaris, which triggers the formation of

Subretinal Neovascularization Following Metallic Intraocular Foreign-Body Trauma

Two patients developed subretinal neovascularization after chorioretinal injury from a metallic intraocular foreign body. In the first patient, a metallic foreign body struck the retina temporal to the macula and settled inferiorly. Eight months later, subretinal neovascularization developed at the initial impact site. In the second patient, a piece of silver wire became embedded in the retina and choroid near the macula, and subretinal neovascularization occurred six months later at the nasal end of the wire. In both patients, the subretinal neovascularization was confirmed with fluorescein angiography and successfully obliterated with argon laser photocoagulation.

Long-Term Visual Acuity Results After Penetrating and Perforating Ocular Injuries

Of 33 consecutive patients (30 males and three females, ranging in age from 5 to 48 years) with penetrating ocular injuries, 13 had retained metallic intraocular foreign bodies. The remaining 20 had no retained foreign bodies and their injuries were generally more severe lacerating or double perforating injuries. Magnet extraction was used for foreign body extraction when possible, and pars plana posterior vitrectomy was used only for late complications. The long-term visual acuity results indicated that wound repair, conventional magnet extraction, and removal of traumatic cataract and anterior vitreous blood through a limbal incision is still a viable treatment for many such injuries.

Pediatric ocular injuries in Lesotho.

One hundred and ten children were evaluated in a prospective study in Lesotho to determine the pattern of pediatric ocular injuries in a developing African country. The pattern was found to be the same as that of developed countries regarding increased incidence in boys, frequency of accidental, self-inflicted and assault injuries, and high incidence of corneal lacerations, traumatic cataracts, hyphemas, and lid lacerations. The pattern differed from developed countries in the absence of injuries due to arrows, airgun pellets (BBs), fireworks, toys and chemical burns, the absence of orbital fractures, intra-ocular metallic foreign bodies, and rarity of retinal detachment, and the generally poor visual results following perforating ocular injuries. An information campaign is advocated in Lesotho to aid in the prevention of pediatric ocular injuries.

Bacterial contamination of intraocular metallic foreign bodies

Bacterial flora were cultured from 20 metallic intraocular foreign bodies which were removed by magnetic extraction. Bacterial flora were domonstrated in 35%. Report on the microorganisms isolated, the size of the foreign bodies and the time between the penetration and the magnetic extraction operation in relation to the contamination.

Two cases of Retained Metallic Intra-Ocular Foreign Body

Two cases of Retained Metallic Intra-Ocular Foreign Body

Physiopathology and Clinical Aspects of the Electroretinogram.

This interesting and useful report to the XLVII Congress of the Italian Ophthalmological Society at Palermo in 1963 contains a complete bibliography following each of its three sections. The first deals with technic and physiology, and the second with physiopathology. The last portion reviews the clinical applications of electroretinography in diseases of the optic nerve, retina, and choroid, in glaucoma and myopia, in functional changes, and in intoxications and intraocular metallic foreign bodies.

Intraocular Metallic Foreign Bodies Following Cataract Extraction

This report describes retained intraocular metallic foreign bodies found in seven eyes after cataract extraction at the Illinois Eye and Ear Infirmary. The first case was seen in October, 1953, when a golden-colored, metallic-like foreign body was noted deep in the healed corneal wound of a patient who had had cataract surgery one month previously. The following month a similar foreign body was noted lying on the iris in another eye that had persistent, unexplained iritis following an uncomplicated lens extraction. In the following months five additional eyes which had recently been operated on were found to contain similar foreign bodies. In every case a gold-plated Bell erisophake had been used during the operation. These findings stimulated an investigation of our instruments, which revealed that every gold-plated erisophake used at this institution had a roughened surface, as seen on examination with the naked eye. On examination under high magnification,

The giant magnet and metallic intraocular foreign bodies

The giant magnet and metallic intraocular foreign bodies