Abstract Listings 2024

A Novel Technique for Removal of ‘Hard-to-Find’ Metallic Foreign Bodies in the Posterior Orbit

Author: Farnaz Javadian
Base Hospital / Institution: Queen’s University

ePoster presentation

Abstract ID: 24-249

Purpose

Intra-orbital foreign bodies from penetrating injuries can be challenging to remove in the operative setting. We report a case of a 59-year-old female with a globe rupture and retained 8 mm metallic foreign body in the posterior orbit. To expedite localization and removal, we employed the SentiMag® probe, developed for breast cancer 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.


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 services deemed the status of the globe beyond further surgical repair with no expected visual improvement. The patient preferred to proceed with 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 was 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.


Additional Authors

First name Last name Base Hospital / Institution
Vladimir Kratky Queen’s University

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