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Helen R. Moreira, Michele S. Todman, Paul J. Botelho; Concurrent Corneal and Intralenticular Metallic Foreign Bodies. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5679.
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To report the first case involving both a corneal metallic foreignbody (CMFB) and an intralenticular metallic foreign body inthe setting of metal on metal grinding.
A case report.
A 31-year-old male presented to the ophthalmology clinic afterhaving a portion of a CMFB in the right eye removed in the emergencyroom the previous day. The patient's corrected visual acuitywas 20/30 in the right eye and 20/25 in the left eye. On slitlamp biomicroscopy examination, a Seidel negative corneal lacerationwas noted with an intraocular pressure of 16 in the right eye.In addition, there was an iris transillumination defect anda structure suspicious for an intralenticular foreign body inthe posterior lens. A computed tomography scan confirmed theintralenticular foreign body. In the operating room, magnetremoval of the foreign body was performed along with phacoemulsification,and placement of an intraocular lens in the sulcus secondaryto a posterior capsular break where the intraocular foreignbody had previously been located. Four months post operatively,the patient's visual acuity was 20/20 in the right eye withcorrection.
In the setting of metal on metal grinding with a resultant CMFB,a high index of suspicion for an intraocular metallic foreignbody is warranted. A comprehensive ophthalmologic examinationand imaging may be necessary, since these injuries can self-sealand give the false appearance that full corneal penetrationhas not occurred.
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