Missed intraocular foreign body masquerading as intraocular inflammation: two cases

Yeniad, Barış; Beginoglu, Muhittin; Özgün, Cahit

doi:10.1007/s10792-010-9350-7

Cited by 8 publications

(4 citation statements)

References 8 publications

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“…1,[5][6][7] Long-term sequelae of retained foreign bodies largely depend on their composition but have been reported to cause chronic intraocular inflammation and ocular siderosis. 8,9 In addition, the migration of foreign bodies poses a further danger to intraocular structures, such as the corneal endothelium or retinal tissue. 10,11 Thus far, 3 case reports have described intraoperative fractures of phacoemulsification probe tips.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative phacoemulsification tip fracture

Kumar,

Toia,

Khan

2023

JCRS Online Case Rep

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Introduction: Intraoperative instrument fractures pose a serious risk during cataract surgery through the retention of metallic foreign bodies and subsequent injury to intraocular structures. Patient and Clinical Findings: An 83-year-old woman underwent phacoemulsification and insertion of an intraocular lens, during which an intraoperative phacoemulsification tip fracture was encountered during quadrant removal. Diagnosis, Intervention, and Outcome: A thorough examination of the operative field revealed the broken tip fragment in the drape bag, with no intraocular fragments. The surgery was completed with a replacement phacoemulsification probe without issues, and the patient made an uneventful recovery. Conclusions: Early diagnosis and management after instrument breakage are necessary to prevent the retention of metallic foreign bodies.

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Section: Discussionmentioning

confidence: 99%

Intraoperative phacoemulsification tip fracture

Kumar,

Toia,

Khan

2023

JCRS Online Case Rep

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“…The thin posterior capsule may tear from the sudden collapse of the anterior chamber, leading to an inadvertent touch of the instrument tip (either the proximal second instrument held by the surgeon or the phaco-probe itself). Post-operatively, inflammation is also an indicator of the possible retained fragment, no matter how small it may be [11,13].…”

Section: Casementioning

confidence: 99%

Surgical Instrument’s Tip Fracture During Cataract Surgery

MOKHTAR

2021

MJoSHT

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Purpose: To describe a case of a surgical instrument’s tip fracture during cataract surgery. Method: Case report. Results: We report a case of a 60-year-old gentleman who underwent phacoemulsification of the left eye. It was noted that the tip of the second instrument (lens chopper) was fractured during the last quadrant removal of the opacified lens, which disappeared posteriorly. The surgery was successfully completed, and the intraocular lens appeared stable without posterior capsular rent. An urgent computed tomography scan (CT scan) of orbit was arranged. It showed a round radio opaque foreign body near the lens at the lateral aspect of the left intraocular lens (IOL), measuring approximately 0.3cm. The patient underwent foreign body removal using an intraocular magnet by a vitreoretinal surgeon two days after the phacoemulsification surgery. The patient had an uneventful recovery with a vision of 6/60 pinhole 6/6 at six weeks post operatively. Conclusion: Surgical instrument’s tip fracture is a known complication during phacoemulsification; however, it was under-reported among surgeons. Careful inspection of all instruments before introducing them to the eye is mandatory, and early identification of this condition during surgery may avoid major complications.

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“…11,12,15 Any amount of foreign material within the eye may result in intraocular inflammation, which may prejudice an otherwise excellent visual result. 9 Thus the surgeon must remove any foreign body recognised intraoperatively, whether on instruments (Figure 2) or in the AC itself.…”

Section: Fibres Found In the Eye During And After Pcs Ze Mcpherson Et Almentioning

confidence: 99%

“…Current evidence suggests that the majority of retained intraocular fibres cause little or no inflammatory response. 1 In the absence of fibre-related adverse reactions/complications, such as endophthalmitis, 6,9,11,12,15 surgical removal of fibres, found postoperatively, currently remains unjustified.…”

Section: Fibres Found In the Eye During And After Pcs Ze Mcpherson Et Almentioning

confidence: 99%

Fibres found in the eye during and after phacoemulsification cataract surgery

McPherson¹,

Ku²,

Chong³

et al. 2014

Eye

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Purpose Fibres are regularly found within the delivery cartridge (DC) and in the anterior chamber (AC) during phacoemulsification cataract surgery (PCS) and postoperatively. The purpose of this study was to identify their frequency and possible significance. Setting Dedicated ophthalmic day surgery. Design Prospective, consecutive, singlesurgeon, cohort study. Methods In 639 eyes undergoing PCS, the presence of fibres was documented in or on both the DC and in the AC intraoperatively, and in the AC postoperatively. The intraoperative method of fibre removal was documented. Corrected distance visual acuity (CDVA) was recorded preoperatively, and at day 1, week 1, and week 4 postoperatively. The incidence of clinical cystoid macular oedema (CMO) and endophthalmitis in the retained fibre subcohort was compared with that of the non-fibre subcohort. Results A total of 5.2% of the operated eyes had a fibre or fibres in or on the DC, which in all cases was removed with forceps intraoperatively. A total of 14.6% of operated eyes had a fibre or fibres in the AC intraoperatively; these were removed by irrigation/aspiration. Postoperatively, five eyes (0.78%) had a fibre in the AC. There was no significant difference in postoperative CDVA between the fibre and non-fibre subcohorts (P ¼ 0.26), and no clinically significant CMO or endophthalmitis in either subcohort.

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Missed intraocular foreign body masquerading as intraocular inflammation: two cases

Cited by 8 publications

References 8 publications

Intraoperative phacoemulsification tip fracture

Intraoperative phacoemulsification tip fracture

Surgical Instrument’s Tip Fracture During Cataract Surgery

Fibres found in the eye during and after phacoemulsification cataract surgery

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