Management of postequatorial magnetic intraretinal foreign bodies

17 patients with intraretinal magnetic foreign bodies and vitreous hemorrhage are reported. 15 patients underwent a primary surgical repair consisting of a watertight wound closure and removal of the already swelling cataractous lens in 5 cases. All patients had vitrectomy during the second postinjury week. The foreign body was left in place in 2 cases and removed with intravitreal forceps in 15 patients. Total or partial retinal attachment was achieved in 12 patients (71%). Details of the surgical procedure are described.     

Management of intraocular foreign bodies

Thirty-five consecutive cases of perforating ocular injuries with retained intraocular foreign body (IOFB) are examined in this retrospective study. Of the 35 cases with injuries, 30 (86%) were due to metallic foreign bodies. Of these, 25 (83%) involved foreign bodies of ferromagnetic origin. Magnetic extraction in combination with pars plana vitrectomy (or when possible, magnetic extraction alone) was successfully used to remove these foreign bodies. Even in cases where posterior vitrectomy is indicated, magnetic extraction allows good control of the foreign body during removal minimizing surgical trauma and the subsequent postoperative inflammatory response.     

玻璃体切割治疗48眼金属球内异物的临床分析

目的：探讨玻璃体手术治疗金属球内异物的临床效果以及影响视力预后的因素。

方法：选取我院2010-01/2013-06收治的进行玻璃体切割联合球内异物取出术的球内异物患者47例48眼进行回顾性病例分析,包括视力的变化以及异物大小、术前并发症及就诊时间与视力的关系。

结果：所有患者中有46眼成功完整取出异物,2眼为眶内异物未予取出。术后6mo随访最佳矫正视力均有不同程度的提高(P<0.05),球内异物大小、合并视网膜脱离是影响视力的危险因素(P<0.05)。

结论：玻璃体切割手术对治疗金属球内异物伤有明显的优越性,及时恰当的玻璃体手术对视功能的恢复尤为重要。     

Ferrous intraocular foreign bodies and magnetic resonance imaging

We placed various sized ferrous foreign bodies in and around the eye, sclera, and orbit in a rabbit model before performing magnetic resonance imaging studies. All foreign bodies were detected on plain x-rays. Only one of the largest fragments (3 x 1 x 1 mm) demonstrated movement on exposure to the magnetic field.     

Extraction of magnetic foreign bodies from the clear lens

In 20 patients with magnetic foreign bodies in the clear lens, I closed the apperture in the anterior lens capsule by a fibrin cover after extraction of the foreign body. The lens remained clear in 17 patients; total cataract was formed in three. Two of these three patients had had a foreign body in the lens for a longer period of time, and at the time of the extraction the signs of lens siderosis were marked. The cause of the cataract progression in the third subject was not clear. There were no complications of operation or in the postoperative period.     

睫状体平坦部附近磁性异物的摘出

目的观察分析睫状体平坦部及其附近磁性异物的摘出。方法回顾性分析位于睫状体平坦部附近的磁性异物20例（20眼）。结果CT扫描及X线定位确诊20例眼内磁性异物位于睫状体平坦部及其附近,其中19例进行经巩膜的异物摘出术,1例因伴有玻璃体浑浊而进行玻璃体切除眼内异物摘出联合手术。一次异物摘出成功率为100％。术后视力较术前提高者占90．00％。结论对睫状体平坦部及其附近磁性异物,传统经巩膜的异物摘出手术是一种简单、安全、有效和经济的治疗方案。     

Identification of copper ions in aqueous and vitreous of eyes containing copper and iron foreign bodies.

The reliability of aqueous analysis by the atomic absorption spectrophotometer for copper ion content in samples from eyes containing intravitreal pure copper particles was investigated. It was demonstrated that values of copper ions rose well above the normal in the aqueous as well as in the vitreous of such eyes. The standard deviations of the mean values were generally high. It was also found that a similar copper ion content increase occurred in eyes containing iron particles. The possible clinical implications of these findings are discussed.     

Tolerance of intravitreal povidone-iodine in rabbit eyes

Povidone-iodine is frequently instilled on to the conjunctival surface prior to intraocular surgery in order to prevent septic endophthalmitis. A small amount of povidone-iodine is inevitably introduced into the eye when it is used in this manner. The toxicity of intravitreal povidone-iodine was assessed in rabbit eyes by injecting 0.1 ml of povidone-iodine in concentrations of 0.05%, 0.5% and 5% into the vitreous cavity. The injected eyes were evaluated by clinical examination, anterior segment and fundus photography, endothelial cell counts, electroretinography and histopathology. Compared to control eyes, no changes were observed in all 6 eyes injected with 0.1 ml of 0.05% povidone-iodine solution. 9 of 10 eyes tolerated a concentration of 0.5% with no detectable adverse changes. One eye developed a temporary mild iritis and mild suppression of the ERG. Intra-retinal hemorrhages, edema, arteriolar narrowing and retinal edema were seen one week following injection. Mild retinal necrosis of the same area was seen on histology. All 4 eyes injected with 5% povidone-iodine developed temporary hypotony and iridocyclitis. A dense cataract developed in all eyes. Full thickness retinal necrosis and a profound lasting reduction in the ERG was produced in all of these eyes. No corneal epithelial or endothelial changes were observed in any eye in this series. Low concentrations of intravitreal povidone-iodine likely to be produced by instillation prior to surgery are tolerated by rabbit eyes. The concentrations tolerated by the studied eyes are near reported bactericidal levels.