Surgical Management Of A Penetrating Eye Injury With A Metallic Intraocular Foreign Body And Traumatic Cataract - Case Report
Published 2025 - 43rd Congress of the ESCRS
Reference: PO831 | Type: Poster | DOI: 10.82333/yjvt-nr59
Authors: Dominik Dygas* 1 , Dorota Śpiewak 2 , Wojciech Maruszczyk 2 , Marcin Proniak 2 , Zofia Dygas 3
1DEPARTMENT OF OPHTHALMOLOGY,FACULTY OF MEDICAL SCIENCES IN KATOWICE MEDICAL UNIVERSITY OF SILESIA IN KATOWICE,Katowice,Poland;DEPARTMENT OF OPHTHALMOLOGY,PROF. K. GIBIŃSKI UNIVERSITY CLINICAL CENTER MEDICAL UNIVERSITY OF SILESIA IN KATOWICE,Katowice,Poland, 2DEPARTMENT OF OPHTHALMOLOGY,PROF. K. GIBIŃSKI UNIVERSITY CLINICAL CENTER MEDICAL UNIVERSITY OF SILESIA IN KATOWICE,Katowice,Poland, 3PRYZMAT Okulistyka,Gliwice,Poland
Purpose
We report a case of a 36-year-old male patient referred to our Clinic from another Hospital for surgical management of a penetrating injury to the right eye caused by a metal fragment during wood processing.
Setting
Department of Ophthalmology, Prof. K. Gibinski University Clinical Centre, Medical University of Silesia, Katowice, Poland.
Methods
At admission, BCVA was hand motion only in the right eye and 5/5 in the left. IOP in the right eye was normal on palpation, and the left measured 16 mmHg. Examination revealed conjunctival hyperemia, a smooth, transparent cornea with a self-sealed central perforating wound (Seidel test negative), a moderately deep anterior chamber without inflammation, and a metallic foreign body embedded in the lens. Findings included traumatic cataract and iris damage at 4–5 o’clock. Imaging (CT and USG) confirmed a metallic foreign body in the anterior chamber with no posterior involvement. The globe contour was regular, and the retina was attached without signs of vitreous hemorrhage.
Results
The patient was admitted for surgery and started on anti-inflammatory and antibiotic therapy. IOL power was calculated based on the contralateral eye due to posterior segment inaccessibility and biometric artifacts caused by the foreign body (left eye refraction: planum / -0.5D cyl at 45°). Surgery included removal of the foreign body, phacoemulsification of the traumatic cataract, and in-the-bag IOL implantation. Despite anterior capsular damage, the posterior capsule remained intact. The corneal wound was closed with three single interrupted sutures. Postoperatively, BCVA improved from hand motion only to 0.5/50 by day seven, with a clear anterior chamber, reactive pupil, and normal posterior segment on ultrasound.
Conclusions
The patient reported subjective improvement in visual acuity without complaints. Topical medications were gradually tapered. Future management includes suture removal, ongoing observation, and potential referral for corneal transplantation to address refractive needs.
This case highlights the importance of tailored surgical planning and precise management in complex ocular trauma involving intraocular foreign bodies and associated complications.