Intracapsular Extraction of Intralenticular Magnetic Foreign Bodies.

INTRALENTICULAR magnetic foreign bodies if left untreated lead in most instances to total cataract formation, siderosis, or as a later complication, loss of the eye. Since the use of the magnet has been developed, and powerful hand instruments have made manipulation easier, intralenticular magnetic foreign bodies have been removed by this means via the anterior route. The risk of siderosis is thus excluded, but the risk of cataractous change is not lessened and may even in many cases be hastened by the second traverse of the lens by the foreign body. Needling of the cataract may be necessary, secondary glaucoma may result, or curette evacuation will be advised followed by single or multiple needlings of the capsular remains. In the older patient the presence of a hard nucleus may add to the surgical problem. Most of the patients subjected to this type of trauma are young and the injury occurs at work. Until recently the age of such patients precluded intracapsular extraction because of the toughness of the zonule of the lens. Since the introduction of alpha-chymotrypsin (" Chymar") and Barraquer's corneo-scleral sutures of virgin silk, five intracapsular extractions of cataractous lenses containing magnetic foreign bodies have been performed. The vacuum erisophake, which was used in some of these cases, has the added advantage that the suction cap may be placed over the capsular entry wound to prevent further tearing of the capsule during the extraction. Intracapsular forceps may also be manipulated to grasp the capsule at the appropriate site but do not assert their influence over so great an area. In each case the position of the foreign body was seen in the lens on slit-lamp examination and it was localized by x ray (Sweet's method) and found to be the only radioopaque foreign body present.