Nonmagnetic Intraocular Foreign Bodies Research Articles

RETRACTABLE UROLOGY THREE-PRONGED GRASPING FORCEPS FOR REMOVAL OF LARGE, NONMAGNETIC INTRAOCULAR FOREIGN BODIES.

To demonstrate the use of urology retractable three-pronged grasping forceps in the removal of a large, round, and nonmagnetic intraocular foreign body (IOFB) that was difficult to remove with other surgical instruments. Extraction of a 3.0 mm lead shot pellet embedded in vitreous hemorrhage was attempted with multiple surgical instruments including an intraocular magnet, IOFB forceps, and two tools designed for urology stone removal: a three-pronged grasping forceps and a nitinol basket extractor. Owing to the round and smooth surface, large size, and nonmagnetic nature of the IOFB, extraction was challenging and failed with multiple other surgical instruments. The wide and secure grasp of the grasping forceps allowed for swift IOFB extraction without iatrogenic injury to the retina. The grasping forceps offer an effective and safe method for removal of large, round, and nonmagnetic IOFBs.

Perfluorocarbon liquid-assisted intraocular foreign body removal

Traumatic ocular injury is an uncommon yet leading cause of monocular blindness among the working-age group. Retained intraocular foreign body (IOFB) are associated with 41% of open globe injuries. Pars plana vitrectomy is often required for posterior segment IOFB removal. Advances in vitreoretinal surgical techniques and instrumentation have resulted in better treatment outcomes with reduced ocular morbidity. We report a case of modified ILM forceps with perfluorocarbon liquid-assisted non-magnetic IOFB removal in a young man after a motor vehicle accident with zone one open globe injury and a large glass IOFB in the right eye. We describe the use of perfluoro-N-octane to slide the IOFB extramacularly and reorient the IOFB plane for stable and safe retrieval by ILM end-gripping forceps. The modified design of the ILM end-gripping forceps with adjunctive use of perfluorocarbon liquid in pars plana vitrectomy reduces slippage during IOFB extraction and prevents collateral iatrogenic retinal injury.

A Cross-Knotted Suture Basket Technique for Large Nonmagnetic Intraocular Foreign Body Removal.

Purpose To report a novel technique of cross-knotted suture basket and to test its effectiveness in large nonmagnetic intraocular foreign body (IOFB) removal. Methods A 7/0 Vicryl suture was cut in half and cross-knotted, and four ends were introduced into a 23G needle to form a basket. Pig eyes were used to set up the IOFB model, and the effectiveness of the suture basket in the removal of large nonmagnetic intraocular foreign bodies was tested. Results Several modifications can be made to adapt to different situations. For the materials (stone, metal, glass, and wood) and shapes (irregular, spherical, and rectangle) of large IOFB tested, the cross-knotted suture basket successfully removed all kinds of IOFBs. Conclusion The suture basket technique provides an accessible, safe, and effective alternative in large nonmagnetic IOFB removal. It can be adapted and interchangedand also worth's further clinical investigations.

Perfluorocarbon liquid-assisted intraocular foreign body removal.

We describe the benefits of perfluoro-N-octane (PFO), a perfluorocarbon liquid, in the removal of nonmagnetic intraocular foreign bodies (IOFBs) from the macula and posterior segment. Two consecutive cases of posterior segment IOFB were reviewed. An 18-year-old male presented to the emergency room after a motor vehicle accident with a zone 1 open globe injury and large glass IOFB in the left eye. A 53-year-old male presented to the emergency room with a history of a 3-week delayed presentation of a zone 1 open globe injury from a nail to the right eye. He was found to have a metallic IOFB. In both cases, PFO was used to slide the nonmagnetic IOFBs outside of the macula for safer retrieval. PFO was also able to protect the posterior pole from IOFB drops during early attempts at removal. PFO can be a useful surgical adjunct to pars plana vitrectomy in the removal of certain nonmagnetic IOFBs.

25-Gauge active aspiration silicon tip–assisted removal of glass and other intraocular foreign bodies

ObjectivesTo describe the use of 25-gauge active aspiration silicon tip in removal of intraocular foreign bodies, including glass. DesignRetrospective, noncomparative, interventional study. ParticipantsEleven eyes of 11 patients who underwent the procedure between January 2013 and April 2015. Material and MethodsThe study included 10 males and 1 female with a mean age of 31.27 ± 9.64 years (range 12–45 years). All eyes in which 25-gauge active aspiration silicon tip–assisted removal of intraocular foreign body (IOFB) was done in a sutureless vitrectomy setup, irrespective of the nature of IOFB, were included. We excluded the participants with less than 6 months of postoperative follow-up. The primary outcome of the study was to assess the feasibility and reproducibility of 25-gauge active aspiration silicon tip–assisted removal of IOFB. The secondary outcome measures included change in best-corrected visual acuity (BCVA), and intraoperative and postoperative complications. ResultsThere were iron (6), glass (2), wooden (1), pellet (1), and stone (1) IOFBs, for which 25-gauge active aspiration silicon tip–assisted removal was done successfully. The mean BCVA in Snellen’s decimal equivalent improved significantly from 0.14 ± 0.16 to 0.34 ± 0.36 with a mean follow-up of 12 months (range 6–24 months). Intraoperatively, drop of IOFB because of loss of vacuum was observed in 2 eyes. Postoperatively, cystoid macular edema with epiretinal membrane was seen in 1 eye. There were no other intraoperative and postoperative complications. ConclusionsUse of 25-gauge active aspiration silicon tip to assist removal of magnetic and nonmagnetic IOFBs is a feasible and reproducible procedure, and required instrumentation is readily available in present-day vitrectomy era.

Removal of a Giant Nonmagnetic Intraocular Foreign Body Using Micro Alligator Forceps

To introduce a new method for removal of a giant nonmagnetic intraocular foreign body using micro alligator forceps. Eleven patients underwent pars plana vitrectomy and lensectomy. The micro alligator forceps were used to grasp and extract the giant nonmagnetic intraocular foreign body through a sclerocorneal tunnel. All patients underwent surgical removal of the intraocular foreign body successfully without any intraoperative complications. The alligator forceps were operational in the intraocular environment and effective in surgical maneuvers. There was no accidental slippage during the procedures. Micro alligator forceps are a feasible option for removal of giant nonmagnetic intraocular foreign body during vitreoretinal surgery and offer advances in terms of operating stability and surgical safety.

Extraction of intraocular foreign body at or near the ciliary body under endoscopic vitrectomy

To study the feasibility and effectiveness of the extraction of intraocular foreign body (IOFB) at or near the ciliary body by using endoscopic vitrectomy. It was a retrospective case series study. Clinical materials and data of 15 patients (16 eyes) with IOFB at or near the ciliary body from July 2002 to December 2010 were analyzed retrospectively. Vitrectomy and IOFB extraction under endoscope were conducted in all cases. Thirty six IOFB (18 magnetic and 18 nonmagnetic IOFBs) were extracted successfully. The size of IOFB ranged from smaller than 1 mm×1 mm×1 mm to 9 mm×6 mm×4 mm. Among them, 31 IOFB were extracted from ciliary body or nearby and 5 IOFB were located at other places. The cornea was opaque before the operation in 11 eyes. Postoperative visual acuity was improved in 12 eyes. Vision was improved from finger-counting and below to 0.1-0.3 in 4 eyes. Intraocular pressure was normal in 14 eyes. The retina was reattached in 12 eyes. The cornea was clearer than before in 8 eyes. After the end of the fellow-up, vision was remained in finger-counting and below in only 7 eyes. There was almost no blind spot by using endoscope to observe the ciliary body, periphery retina tear or other pathological changes, the IOFB at or near ciliary body and the whole retina in the vitrectomy. This makes the extraction of IOFB at or near the ciliary body and the conduct of cyclophotocoagulation more accurate and simple.

Clinical analysis on extraction of non-magnetic intraocular foreign bodies in posterior segment by vitrectomy

目的 评价经玻璃体切除术治疗眼后段非磁性异物的临床效果.方法 回顾性分析经玻璃体切除术治疗62例(65眼)眼后段非磁性异物的临床资料.结果 所有患者均一次手术成功摘出异物.术后视力情况:合并视网膜脱离者42眼,术后视力提高12眼(28.57%),无变化28眼(66.67%),视力下降2眼(4.76%).未合并视网膜脱离者23眼,术后视力提高15眼(65.22%),视力无变化8眼(34.78%).结论 经玻璃体切除术可有效地摘出眼后段非磁性异物,但术后效果受异物长期眼内存留的影响而较差.未合并视网膜脱离者视力预后明显优于合并有视网膜脱离者。

Utilizing Gravity in the Removal of a Large Intraocular Foreign Body

This article describes an unconventional technique for the removal of a nonmagnetic intraocular foreign body that is too large or too smooth to be grasped by intraocular forceps and does not float on perfluorocarbon liquids. By flipping the patient to a face-down position and allowing the gravitational forces to help remove the object, one can hope to avoid further ocular damage. This approach should be considered in similar cases of very large and smooth intravitreal foreign bodies to avoid severe and irreversible damage to the retina.

Management of posterior segment foreign bodies and long-term results.

The management of 158 posterior segment intraocular foreign bodies (IOFB) was retrospectively analyzed: transscleral magnet extraction via the pars plana was used for 40 magnetic IOFB, transscleral extraction via the IOFB bed for 35 magnetic and 4 non-magnetic IOFB, pars plana vitrectomy (PPV) for 44 magnetic and 32 non-magnetic IOFB, and open-sky vitrectomy for 3 non-magnetic IOFB. Final visual acuity of 0.02 and better was achieved in 104 out of 119 magnetic IOFB (87%) and 24 out of 39 non-magnetic IOFB (62%), and final visual acuity 0.05 and better in 79 magnetic IOFB (66%) and 17 non-magnetic IOFB (44%). Transscleral extraction via the IOFB bed under ophthalmoscopic control and IOFB removal by PPV proved to be the operations of choice for an increasing number of IOFB. For magnetic IOFB, these techniques yielded better final functional results than transscleral magnet extraction via the pars plana. Final visual acuity did not depend on the interval between injury and IOFB removal, and with regard to the risk of endophthalmitis, IOFB need not be considered an absolute indication for immediate intervention. IOFB size up to 5 mm2 and initial visual acuity of 0.5 and better were significant positive factors for both magnetic and non-magnetic IOFB.

Experiences with Extraction of 232 intraocular and 30 intraorbital non-magnetic foreign bodies

The characteristics, localisation and extraction of 262 non-magnetic intraocular and intraorbital foreign bodies in 148 consecutive patients are described. The postoperative visual acuity results show no change in 45%, an improvement in 35% and a worsening in 20% of the eyes. The precise dynamic localisation before and during surgery, and particularly the intraoperative visualisation of the non-magnetic foreign bodies are to be considered as the most important points in surgical treatment of these cases.

Vitrectomy Techniques in the Management of Selected Penetrating Ocular Injuries

Closed vitrectomy techniques provide new capabilities to treat severe penetrating ocular injuries involving posterior segment structures. With these methods damaged iris tissue, lens, and vitreous can be removed and intraocular opacities can be cleared to identify and treat any retinal damage. Removal of damaged vitreous also prevents later cyclitic membrane formation and traction on the retina. The vitrectomy technique can be combined with additional methods to treat other conditions including nonmagnetic intraocular foreign bodies. We present the rationale and technique of vitrectomy together with the results of treatment in 51 consecutive cases of penetrating ocular trauma. Guidelines are offered for management of severe penetrating injuries.

A Suction Tip for Controlled Removal of Nonmagnetic Intraocular Foreign Bodies

I used a soft-tip suction needle during a vitrectomy procedure to life glass foreign bodies away from the retina so they could be more easily and safely grasped with foreign-body extraction forceps. The use of the instrument reduces the chance of inadvertent scraping of glass fragments or instruments against the retina during the removal.

Advances in Ophthalmology.

Volume 21 of Advances in Ophthalmology consists of two reviews and five original papers. H. Neuhauer reviews the problem of nonmagnetic intraocular foreign bodies and advocates greater effort to remove them. O. M. Ferrer presents a five-year review of fluorescein fundus photography which includes discussion of advances both in technique and application. original articles are as follows: The Ocular Signs of Vertebrobasilar Insufficiency, by E. Rosselet. The Treatment of Dendritic Keratitis, by K. Graupner, S. Klein, and F. Muller. Electroretinography and Electrooculography in Diseases of the Posterior Pole of the Eye, by J. Francois, A. de Rouk, and D. Fernandez-Sasso. Measurement of the Penetration of Locally Applied Steroids in the Eye With the Help of Radioactive Isotopes, by J. Draegor and G. Tams. Study of Metabolic Pathways in the Normal and Pathologic Lens, by R. Sevin. These original communications are detailed and have extensive bibliographies. two reviews and

Contactless detection of magnetic and nonmagnetic intraocular foreign bodies

Contactless detection of magnetic and nonmagnetic intraocular foreign bodies

New instrument for removing metallic, non-magnetic intra-ocular foreign bodies.

New instrument for removing metallic, non-magnetic intra-ocular foreign bodies.

Magnetic vs nonmagnetic intraocular foreign bodies. An ultrasonic determination.

An ultrasonic method for preoperative differentiation of the nonmagnetic from the magnetic intraocular foreign body has been described. This method is useful when the intraocular object cannot be seen ophthalmoscopically.