gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Intralentar foreign body : surgical technique, diagnostical difficulties

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  • corresponding author N. Czumbel - Department of Ophthalmology Semmelweis University Budapest, Hungary

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogDO.10.01

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2004

© 2004 Czumbel.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Two cases are presented. Two young men while working with a hammer suffered penetrating injury with intraocular foreign body. The corneal penetrating wound closed spontaneously. In the first case the foreign body was located in the middle of the crystalline lens, in the optical axis. No inflammatory signs were present and the visual acuity was 09. After 3 months the central lens opacity progrediated, the visual acuity decreased. Through a clear corneal incision, after a continuous curvilinear capsulorhexis (CCC) a part of the soft cortex was aspirated. Achieving the foreign body it was removed under viscoelastic material with an intraocular magnet. After hydrodissection the remaining part of the lens was aspirated with an irrigating-aspirating canula. A foldable posterior chamber intraocular lens (PCL) was implanted in the capsular bag. In the second case the patient was presented with a CT scan revealing the foreign body behind the lens, in the periphery. The fundus examination showed no evidence of foreign body, but it was impossible to check the far periphery due to an incomplete pupillary dilation. The patient's visual acuity was 1,0. During a standard 3 port pars plana vitrectomy and scleral indentation the foreign body was visualised in the lens periphery, behind the iris. Through a clear corneal incision, under viscoelastic material the foreign body was mobilised, moved in the anterior chamber and removed with an intraocular magnet. The CCC, hydrodissection, lens aspiration and the posterior chamber lens implantation were performed in the same way as in the first case.


In the first case it was easy to make a correct diagnosis, the foreign body was visible. In the second case the foreign body preoperatively was misdiagnosed as being intravitreal. The foreign body removal presented no difficulties during the surgical procedure, the lens removal and the PCL implantation was performed without complication. After 6 weeks follow-up both patients gained visual acuity of 1,0 in the operated eye.