Vitrectomy for Removal of Posterior Segment Intraocular

I ntraocular foreign bodies (IOFBs) present unique surgical challenges, particularly when the posterior segment is involved. Risk factors for IOFB after ocular injury include youth, male gender, work-related injury, metallurgy, and battlefield or blast injury. If either traumatic endophthalmitis or traumatic cataract is present, there should be a high index of suspicion for IOFB, and imaging studies should be obtained. Possible consequences of posterior segment IOFB include endophthalmitis, toxicity (such as siderosis or chalcosis), cataract, retinal detachment (RD), intraocular hemorrhage, secondary choroidal neovascular membrane, and sympathetic ophthalmia. The most common intraocular location of a retained foreign body is within the vitreous humor. These cases require vitrectomy with foreign body removal either through the pars plana or anteriorly through the pupil and clear cornea after lensectomy. Retinal or subretinal IOFBs frequently cause widespread hemorrhage and retinal damage and may require retinotomy. Postoperatively, there is a high risk of RD associated with proliferative vitreoretinopathy (PVR). This article presents helpful surgical techniques and reviews the literature on the surgical management of these complex cases. CASE EXAMPLE A 33-year-old man was referred from an outside emergency room with a red, painful left eye (OS; Figure 1). Five days earlier, he presented to the ER after work with mild pain OS. He worked as a furniture mover, and all week long he had been removing chairs that were staVitrectomy for Removal of Posterior Segment Intraocular Foreign Bodies