The Innovative Use of Entry Site for Extraction of Retained IOFB Lodged in

the Ciliary Body Area

Dr Manoj Saxena Dr Vipin SahniDr Meeta Saxena

Prakash Netralaya & Retina Foundation, Aligarh, INDIA

No Financial Disclosures

SIGNS AND SYMPTOMS•Patient presented with h/o injury while working with a chisel and hammer•On examination, entry wound was found at 8 o’clock position posterior to the ora serata•Plain X-ray showed retained IOFB•B Scan showed vitreous haemorrhage with IOFB placed anteriorly and a shallow RD•CT Scan localized the IOFB in the ciliary body at 8 o’clock position

MATERIALS AND METHOD

We started off by repairing the entry wound in two layers.

23 G pars plana vitrectomy was done to clear the massive vitreous haemorrhage.

We could locate the the large retinal break corresponding to the entry site but IOFB

was not seen as it was stuck in the ciliary body

The retina was settled by endodrainage and FAX

The foreign body was located by indentation at 8 o’ clock in the

ciliary body area.

The entry wound was reopened. A 19G rare earth magnet was introduced to

dislodge the IOFB and bring to the open entry wound .

The IOFB was eventually extracted by using a larger magnet and the entry

wound was closed.

The break and retinotomy were lasered and silicone oil was injected for long term

tamponade.

CONCLUSIONS•This is an innovative use of entry wound to extract a metallic retined IOFB lodged in the ciliary body area•The procedure was atraumatic to the lens and the retina remained settled•No new sclerotomy was required to remove the IOFB•No additional instrument like endoscope was required•By keeping the IOFB from falling on the central retina, injury to the macula was avoided