Clinical Report: Tips for Removing Foreign Bodies

Overview

This report discusses various techniques for the removal of intraocular foreign bodies (IOFBs) from the posterior segment, emphasizing the use of the inferior port for extraction. The findings highlight the importance of minimizing trauma and avoiding complications during the removal process.

Background

Intraocular foreign bodies are a significant concern in ocular trauma, with potential risks including vision loss and retinal injury. Effective removal techniques are crucial for preserving ocular integrity and preventing complications such as endophthalmitis. Understanding the various surgical approaches can enhance outcomes in patients with IOFBs.

Data Highlights

No numerical data or trial data provided in the source material.

Key Findings

• Utilizing the inferior port for IOFB removal can reduce the risk of dropping the foreign body.
• Direct extraction through an enlarged sclerotomy allows for the use of the surgeon's dominant hand but carries risks of dislodging the IOFB.
• The handshake technique facilitates controlled transfer of the IOFB but may lead to turbulence and hypotony.
• Ophthalmic viscosurgical devices (OVD) can stabilize the IOFB during instrument exchange, improving control.
• Early removal of toxic metal IOFBs is recommended to prevent complications such as endophthalmitis.

Clinical Implications

Surgeons should consider the nature of the IOFB and the patient's clinical status when selecting a removal technique. Employing the inferior port approach may enhance safety and efficacy in IOFB extraction. Preoperative planning and the use of adjuncts like OVD can mitigate risks during surgery.

Conclusion

Effective management of intraocular foreign bodies is essential for preserving vision and preventing complications. The choice of surgical technique should be tailored to each case to optimize outcomes.

References

1. Raj Rathod, MD • William F. Mieler, MD, Retinal Physician, 2011 -- An Update on the Management of Intraocular Foreign Bodies
2. GABRIEL KATZ, MD · JOSEPH MOISSEIEV, MD, Retinal Physician, 2009 -- Posterior-segment Intraocular Foreign Bodies: An Update on Management
3. AAPPO/APVRS/ARI, 2025 -- International Consensus on IOFB Management
4. BJS (British Journal of Surgery) — Endoscopic incision of the appendix sphincter for faecolith extraction
5. The Impact of XLIF on Revision Spine Surgery for Failed Interbody Implants: An Overview of Techniques, Results, and Clinical Indications
6. https://www.aapp-ophth.org/wp-content/uploads/2025/07/IOFB_for_PDF_20250627_typeset.pdf
7. Early versus Delayed Vitrectomy for Open Globe Injuries: A Systematic Review and Meta-Analysis - PubMed
8. The Use of Preoperative Prophylactic Systemic Antibiotics for the Prevention of Endopthalmitis in Open Globe Injuries: A Meta-Analysis - ScienceDirect