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Intra-orbital knife blade foreign body: a case series
Shaheer Ballim1, B Gundry, S Mahomed
1Department of Ophthalmology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. shaheerballim@gmail.com.
South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
|November 12, 2013
Summary
This study details three cases of intra-orbital knife blade foreign bodies. A novel double bone nibbler technique shows promise for safe removal and good visual outcomes.
Area of Science:
- Ophthalmology
- Trauma Surgery
Background:
- Orbital foreign bodies, particularly knife blades, present significant surgical challenges.
- Prompt and precise management is crucial to prevent vision loss and preserve ocular structures.
Observation:
- A retrospective case series of three patients with intra-orbital knife blade foreign bodies resulting from assault.
- Blades exhibited consistent orientation within the orbit, with varying depths and one instance of significant vascular injury.
Findings:
- Two patients achieved good visual outcomes after foreign body removal; one required enucleation due to the severity of injury.
- A "double bone nibbler" technique facilitated controlled removal in two cases.
- The third blade, lacking a handle, was removed with minimal globe manipulation.
Implications:
- Pre-operative vascular injury assessment is critical before surgical intervention.
- The "double bone nibbler" technique offers a promising approach for rigid, embedded blades.
- Successful removal can lead to favorable visual prognoses in selected cases of orbital knife blade injuries.
