Combination management by C-arm fluoroscopy and extraocular muscle severance for penetrating ocular trauma with a retrobulbar foreign body

ABSTRACT

We report here the successful removal of a retrobulbar metallic foreign body in a patient with penetrating ocular trauma by a transconjunctival approach and combination management with C-arm fluoroscopy and extraocular muscle severance. A 37-year-old man sustained a penetrating injury to the right eye while using an iron hammer. Initial slitlamp examination revealed a corneoscleral laceration, iridocele, anterior chamber collapse, and a traumatic cataract. Visual acuity in the right eye was limited to the perception of hand motion. Computed tomography revealed an orbital foreign body in the retrobulbar area. The patient underwent corneoscleral suturing, severance of extraocular muscles, removal of the foreign body with guidance by C-arm fluoroscopy, pars plana lensectomy, and pars plana vitrectomy. Combination management with C-arm fluoroscopy and extraocular muscle severance may thus be a suitable approach to the removal of a retrobulbar metallic foreign body.

KEYWORDS:

• Double perforation
• extraocular muscle surgery
• fluoroscopy
• penetrating injury
• retrobulbar foreign body

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Notes on contributors

Makoto Hatano

M.H. drafted the manuscript, T.O. and K.K. reviewed the literature, K.-H.S provided clinical advice, and all authors contributed to the treatment. All authors also read and approved the final manuscript.

Kazuhiro Kimura

M.H. drafted the manuscript, T.O. and K.K. reviewed the literature, K.-H.S provided clinical advice, and all authors contributed to the treatment. All authors also read and approved the final manuscript.