Removal of intraocular foreign body in anterior chamber angle with prism contact lens and 23-gauge foreign body forceps

AIM:To introduce a novel approach in removal of anterior chamber angle foreign body(ACFB) using a prism contact lens and 23-gauge foreign body forceps.METHODS:Data of 42 eyes of 42 patients who had undergone removal of ACFB using a prism contact lens and 23-gauge foreign body forceps from January 2008 to October 2013 were collected and analyzed. Twenty eyes in group A received the conventional approach by using toothed forceps through corneal limbus incision, and 22 eyes in group B underwent the novel method through the opposite corneal limbus incision. RESULTS:The success rate of ACFB once removal was 75%(15/20) in group A, and 100%(22/22) in group B. The average operation time of group A was significantly longer compared with group B(34.9±9.88 min vs 22.13±8.85min; P<0.05). The average size of corneal limbus incision in group A was significantly larger than that of group B(4.85±1.89 mm vs 3.95±1.17 mm; P<0.05). The corneal limbus incision suturing were conducted in all eyes in group A, and only 5 eyes in group B. CONCLUSION:Removal of ACFB using a prism contact lens and 23-gauge foreign body forceps is a safer, more effective, and convenient technique compared with the conventional approach.

Open globe injury in Hospital Universiti Sains Malaysia- a 10-year review

AIM:To identify the aetiology of open globe injuries at Hospital Universiti Sains Malaysia over a period of 10y and the prognostic factors for visual outcome.METHODS:Retrospective review of medical records of open globe injury cases that presented from January2000 to December 2009.Classification of open globe injury was based on the Birmingham Eye Trauma Terminology(BETT).Records were obtained with hospital permission via the in-house electronic patient management system,and the case notes of all patients with a diagnosis of open globe injury were scrutinised.Patients with prior ocular trauma,pre-existing ocular conditions affecting the visual acuity,contrast sensitivity,central vision or corneal thickness,as well as those with a history of previous intraocular or refractive surgery were excluded.Analysis of data was with SPSS version20.0.Ordinal logistic regression analysis was used to examine the association between prognostic factors and visual outcome.RESULTS:This study involved 220 patients(n=222eyes).The most common place of injury was the home(51.8%),followed by the workplace(23.4%).Among children aged less than 16y of age,domestic-related injury was the predominant cause(54.6%),while in those aged 16y and above,occupational injuries were the most common cause(40.0%).Most eyes(76.5%)had an initial visual acuity worse than 3/60,and in half of these,the visual acuity improved.The visual outcome was found to be significantly associated with the initial visual acuity(P<0.005),posterior extent of wound(P<0.001),length of wound(P<0.001),presence of hyphaema(P<0.001)and presence of vitreous prolapse(P<0.005).CONCLUSION:The most common causes of open globe injury are domestic accidents and occupational injuries.Significant prognostic factors for final visual outcome in patients with open globe injury are initial visual acuity,posterior extent and length of wound,presence of hyphaema and presence of vitreous prolapse.Awareness of the factors predicting a poor visual outcome may be helpful during counselling of patients with open globe injuries.