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Management of a large metal intraocular foreign body

  • Tina Felfeli
    Affiliations
    Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.

    Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.
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  • Efrem D. Mandelcorn
    Correspondence
    Correspondence to Efrem D. Mandelcorn, MD, Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto Western Hospital, University Health Network, 6E-432, 399 Bathurst St, Toronto, ON M5T 2S8 Canada
    Affiliations
    Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.

    Department of Ophthalmology, Toronto Western Hospital, Toronto, Ont.
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Published:April 14, 2021DOI:https://doi.org/10.1016/j.jcjo.2021.03.009
      A 49-year-old man had been seen 1 month prior by a general ophthalmologist for a healing corneal abrasion. On examination, there was a dense vitreous hemorrhage and a subtle iris transillumination defect suspicious for an occult intraocular foreign body (IOFB; Fig. 1A). A computed tomography scan confirmed an IOFB that extended from the inferior posterior iris to the posterior pole (Fig. 1B). Intraoperatively, the traumatic cataract was removed along with the ruptured capsular bag (Video 1, available online). Given its size, the IOFB was removed through a corneal incision and the pupil (Fig. 1C), measuring 17 mm (Fig. 1D). An endolaser was applied for retinal tears, silicone oil tamponade was placed, and the patient was left aphakic. Subsequently, silicone oil was removed, and an intraocular lens was placed and suture fixated to the iris given the absence of capsular support, and the final vision was 20/30.
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