Affiliation:
1. The Khabarovsk Branch of S. Fyodorov Eye Microsurgery Federal State Institution
2. The Khabarovsk Branch of S. Fyodorov Eye Microsurgery Federal State Institution;
Postgraduate Institute for Public Health Workers;
Far Eastern State Medical University
3. The Khabarovsk Branch of S. Fyodorov Eye Microsurgery Federal State Institution;
Far Eastern State Medical University
Abstract
Purpose. Demonstration of non-standard clinical case of removing large fragment of metal wire from the eye. Patient and methods. Patient, 37 years old, with penetrating right eye injury with intraocular foreign body (IOFB) introduction — a fragment of metal wire. After unsuccessful attempt to remove IOFB during primary repair of eye injuries lacerations by ophthalmologist of the surgical department of the district hospital, he was sent to the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution. On admission: VIS OD — 0.01 uncorrected, intraocular pressure (IOP) — 16 mm Hg (noncontact tonometer TOMEY, Japan). OD — metal IOFB protrudes by 1.0 mm from the corneoscleral laceration in projection of corneal limbus at the 13 o’clock position, postoperative aphakia; according to B-scan ultrasonic data: metallic foreign body of linear shape, 14.3 mm long, about 1.5 mm thick. There is hemorrhage in the vitreous cavity. Results. Initially, conditions for visualization of the vitreous cavity were created by performing 25G vitrectomy. The course of wire location was specified: under the choroid and retina, going out through the sclera in the equatorial region. After conjunctival tweezers expanded wound edges, the embedded fragment of wire was delicately remove: 25 mm in length and 2 mm in diameter. A single retinal break was delimited by cryotherapy and laser photocoagulation. On the 2nd day: VIS OD — 0.3 with diaphragm, uncorrected; IOP — 13 mm Hg. After 3 months: VIS OD — 0.01 sph + 13.0 D = 0.7, IOP — 14 mm Hg. Silicone removal was combined with intraocular lens implantation model RSP-3 (+23D). The next day: VIS OD — 0.3 with diaphragm, 0.5 cyl — 6.0 D ax 170 = 0.5; IOP — 16 mm Hg. Conclusion. Use of 25G vitrectomy for removal IOFB localized between the inner membranes of the eye created optimal conditions for visualizing depth of its penetration, which minimized traumatic impact and avoided severe intra- and postoperative complications.
Publisher
PE Polunina Elizareta Gennadievna
Reference23 articles.
1. Kogan MB, Zadorozhny OS, Petretskaya OS, Krasnovid TA, Korol AR, Pasechnikova NV. Visualization of intraocular foreign bodies located in projection of ciliary body by the method of infrared diaphanoscopy. Journal of Ophthalmology (Ukraine) 2019;4:23‒27 (In Russ.). doi: 10.31288/oftalmolzh201942327.
2. Neroev VV, Gundorova RA, Andreev AA. A pattern of treating patients with intraocular foreign bodies localized in the vitreous. Russian ophthalmological journal. 2010;3(2):16‒19 (In Russ.).
3. Kudasheva GR. Value of clarifying method for determining tactics of removing intraocular foreign bodies from posterior pole of the eye. Bulletin of Medical Internet Conferences 2013;3(7):1016 (In Russ.).
4. Andreyev AA, Gundorova RA, Kodzov MB. Intraoperative ultrasound diagnosis in the removal of intraocular foreign bodies. Annals of ophthalmology. 2008;124(4):36–39 (In Russ.).
5. Boyko EV, Churashov SV. Surgical tactics and technical features of removal of intraocular foreign bodies. Saint Petersburg: VMedA, 2005. 28 p (In Russ.).