A novel technique for removal of ‘hard-to-find’ metallic foreign bodies in the posterior orbit

Theme: Oculoplastic & reconstructive surgery
What: Oculoplastic & reconstructive surgery
Part of: Oculoplastics II: Cutting edge research in oculoplastics! / Oculoplastie II: Recherche de pointe en oculoplastie!
When: 5/31/2024, 02:00 PM - 03:30 PM
Where: Room | Salle 714 A

Abstract

Purpose: Intra-orbital foreign bodies from penetrating injuries can be challenging to detect and remove in the operative setting. We report a case of a 59-year-old female who had presented with a double penetrating ocular injury from an electric weed trimmer and a retained 8 mm metallic foreign body in the posterior orbit. To expedite localization and removal, we employed the SentiMag Magnetic Localization System^®, developed for breast cancer operations in general surgery. To our knowledge, this is the first case of an ophthalmology application using this technology to localize and remove a metallic intra-orbital foreign body.

Study Design: Single case report and review of literature

Methods: This is a single case study of a patient presenting to our academic centre.

Results: A 59-year-old female presented to our emergency department with a left globe rupture, secondary to a broken metal blade from an electric weed trimmer. Imaging confirmed a double perforation of the globe, by an 8 mm metallic missile foreign body which came to rest in the posterior retrobulbar space. The globe was urgently repaired, but the vision remained poor at light perception and the patient continued experiencing pain in the eye. Both the cornea and retina service deemed the status of the globe beyond further surgical help with zero prognosis for improvement in vision. The patient preferred to go straight to enucleation and was referred to our oculoplastics service. In the operating room, the eye was successfully enucleated, and careful palpation of the orbital cavity was done to locate the foreign body. Unfortunately, this turned out to be difficult, as multiple small nodular lesions were removed but turned out to be scar tissue. The SentiMag^® probe was then employed, and it immediately picked up a magnetic signal in the posterior superior orbit, leading to successful removal of the metal fragment. A standard orbital implant was then inserted, and the enucleation was completed in the usual fashion.

Conclusion: To our knowledge, this is the first case describing successful removal of an intra-orbital metallic foreign body, using the SentiMag^® magnetic probe. It appears that this device, used primarily in breast cancer surgery, can also be helpful in orbital surgery for retained metallic objects and represents another useful tool available for the orbital surgeon.

 

Presenter(s)

Presenting Author: Farnaz Javadian

Additional Author(s):

Mariam Tabatadze, Tbilisi State Medical University

Vladimir Kratky, Queen's University

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