gms | German Medical Science

Purpose: To report two cases with a retained large iron nail and perforating injury of the eye achieved favorable visual outcomes.

Methods: Case reports.

Results: Two workers were injured by a nail while working at individual construction place. One iron nail was stabbed in the left eye from upper eyelid and superonasal sclera to temporal scleral with lens involvement, and the other was stabbed from upper eyelid and superotemporal sclera to nasal scleral and cavity. At presentation, their visual acuity was counting fingers. Primary suture, removal of a retained iron nail, pars plana vitrectomy and lensectomy, and laser photocoagulation were performed for these two patients. Additional pars plana vitrectomy, subretinal hemorrhage drainage from retinectomy with perfluocarbon liquid endotamponade, laser photocoagulation, scleral buckle, and silicone endotamponde were performed two weeks later for the second patient. During postoperative six-month follow-up, final best-corrected visual acuity was 20/20 in the first patient and 20/200 in the second. There were no complications in these two patients.

Conclusion: We described two patients with a retained nail and perforating injury of the eye. As most eye injuries are preventable, proper training and use of safety equipment could reduce the incidence of ocular injuries. Expeditious removal of nails, repair of the lacerations, and two-stage surgery can prevent the complications and achieve good final visual outcomes.