Intralenticular Metallic Foreign Body: A Case Report

Background: Intraocular foreign body (IOFB) injuries exhibit variations based on multiple factors, including size, composition, location, type, contamination, the extent of tissue damage, and potential complications that may arise. Case Presentation: This case study describes a 48-year-old male patient who presented to the outpatient clinic with a progressive decline in vision in the right eye lasting three weeks. The patient reported a history of redness in the affected eye, occurring for several days after performing maintenance work. Intraocular pressure measurements were normal for both eyes. The slit lamp examination revealed a corneal opacity near the limbus at the 2 o'clock position in the right eye, along with a small peripheral iris hole aligned with the corneal opacity. Additional diagnostic investigations, including a B-scan ultrasound and a CT scan of the orbit without contrast, were conducted. The B-scan ultrasound showed a clear vitreous and a flat retina, while the CT scan detected a metallic foreign body measuring 3x3 mm. The foreign body was found to be partially embedded in the lens and partially in the vitreous, as confirmed by the imaging. As a result, the patient was admitted to the hospital, and a comprehensive treatment plan was implemented. Topical antibiotics, steroids, cycloplegic, and nonsteroidal anti-inflammatory eye drops were prescribed. The patient underwent cataract surgery with sulcus intraocular lens implantation, combined with a pars plana vitrectomy to remove the foreign body. Additional procedures, such as 360 laser treatment, air-fluid exchange, and injection of SF6 gas, were performed. Conclusion: This case highlights the successful management of an intraocular foreign body injury, emphasizing the significance of prompt diagnosis and appropriate surgical intervention in achieving positive visual outcomes.