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

Abstract

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.

T-shaped pars plana scleral incision to remove large intraocular foreign body

“…The technique of removal of IOFBs is closely related to their size and volume: large IOFBs often require extraordinary measures with routine changes in the surgical plan ( 18 ), while small and medium-sized IOFBs can be extracted directly from the traumatic access wound, which can be from both the sclera and the anterior segment, usually through a corneal incision. Several authors have described their own technique for removing IOFBs from the anterior segment.…”

“…Indeed, due to its size and incarceration, an IOFB extraction through its entry could potentially cause serious iatrogenic lesions to intraocular structures, especially when the size of the wound is far smaller than the maximal diameter of the IOFB, due to its rotation and tumbling ( 15 ). Standard visualization techniques cannot often precisely identify the IOFB’s size and location ( 17 ) and the routinely applied surgical techniques are often inadequate in cases of large IOFBs ( 18 ) and additional sclerotomies need to be performed. Moreover, the scleral incision occasionally needs to be enlarged to extract the IOFB, performing a surgical incision/cut directed parallelly to the corneal limbus ( 19 ).…”