Case 23: Zone I Open Globe Injury with Foreign Body Extending Through the Cornea, Lens, and into Vitreous

Abstract

A 46-year-old man presented with a penetrating Zone I open globe injury of the right eye with a retained intraocular foreign body. The foreign body extended from the cornea, through the anterior chamber and central crystalline lens, stopping in the vitreous cavity. The patient underwent repair via removal of the intraocular foreign body, pars plana lensectomy (PPL) and pars plana vitrectomy (PPV). He had an uncomplicated post-operative course. In an ideal clinical setting, removal of intraocular foreign bodies within the anterior segment spanning into the vitreous benefit from a combined anterior removal with pars plana vitrectomy in an effort to reduce the risk of associated complications (e.g., retinal break or detachment). However, when posterior segment surgeons are not accessible or media opacity, such as corneal clouding, limits adequate visualization, then primary closure takes precedence.