Glass intraocular foreign body removal assisted by biological amniotic membrane: a case report

The extraction of large, sharp-edged nonmagnetic intraocular foreign bodies carries risks of iatrogenic retinal injury with conventional instruments. Biological amniotic membrane is known to be safe for intraocular use, but its application as a protective wrap to remove a foreign body has not been reported to our knowledge. We describe this novel approach.

A man in his forties presented with blurred vision and a retained intraocular glass fragment (5 × 3 × 1 mm) in the left eye, with visual acuity of 20/32. During vitrectomy, attempts to mobilize the sharp fragment using viscoelastic or perfluorocarbon liquid failed. A piece of hydrated biological amniotic membrane (8 × 10 mm) was therefore placed on the adjacent retina. The fragment was maneuvered onto the membrane, which was then folded to envelop it. The wrapped complex was lifted into the anterior chamber. The membrane was removed first, and then the foreign body was extracted through an enlarged corneal incision. Postoperatively, visual acuity remained 20/32, with no retinal complications.

This case suggests that amniotic membrane could theoretically serve as a customizable, protective wrap, potentially safeguarding the retina, increasing stability by engaging sharp edges, and eliminating the need for a snare. This approach may reduce operative time and offers a promising alternative for selected complex intraocular foreign bodies, warranting further evaluation.