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Background: Reporting a case of missed IOFB managed by novel approach of modified endoscope-assisted vitrectomy using Endoscopic cyclophotocoagulation fiber-optic probe for IOFB retrieval.
Case report: Mr MY, a 58 years old Malay gentleman with no underlying medical illness presented with five-month history of left eye gradual onset, painless blurry vision. Symptoms were preceded by a history of high-velocity foreign body which entered the left eye while cutting grass with rotating blade cutter without eye protection, of which was self-treated with over-the-counter topical medications. No history of eye redness or floaters. Systemic examination was unremarkable. On presentation, vision was 6/6 OD and 6/36 OS. Left eye demonstrated rusty pigments on anterior lens capsule with anterior subcapsular cataract with retro-lental streak vitreous opacity and underlying flat retina. Right eye was normal. CT orbit showed radio-dense foreign body in left globe over posterior and infero-lateral to lens. Patient underwent left eye phacoemulsification and vitrectomy surgery. Intra-operatively noted siderosis of lens capsule with no intraocular foreign body (IOFB) found. Repeated imaging showed retained IOFB. Subsequently, he underwent modified endoscope-assisted vitrectomy using Endocyclophotocoagulation (ECP) fiber-optic probe which retrieved fibrosis-covered IOFB infero-temporal to posterior capsule.
Conclusion: Endoscope-assisted vitrectomy is safe and useful in IOFB retrieval by bypassing anterior segment opacities and visualization of anterior structures. The use of ECP probe in endoscope-assisted vitrectomy in this case, which has never been reported before, offers an innovative alternative in places where conventional ophthalmic endoscope is not readily available.
Conflict of interest: We declare that we have no conflict of interest
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