This is a video shared by Dr. Milton David from Campinas – Brazil

In this video we discuss the management of IOFB.
This patient had penetrant ocular trauma with metallic IOFB retained in the posterior segment. The foreign body entered through the limbus and the lens was not involved. The first step in the surgery was to perform phacoemulsification, without IOL implant. Then, a standard 3-port vitrectomy was performed to remove the FB.
Triamcinolone was injected to help the posterior hyaloid detachment and the vitreous base was shaved to facilitate the foreign body removal.
To avoid further damage, hypotony and large sclerotomies, the surgeon decided to perform posterior capsulotomy and the IOFB was dragged to the anterior chamber with a help of a retinal forceps.
So, through an enlarged corneal incision the IOFB was removed.
In the end of the surgery a 3-pieces IOL was implanted in the ciliary sulcus.
In these cases it’s important to perform a careful peripheral examination under scleral depression to treat any retina tear.

Author:
Milton David MD
Campinas – Brazil

Edition:
Filipe Lucatto MD
Juliana Prazeres MD