Lens preservation after intraocular foreign body injuries

Ocular missile injuries often involve the lens. Some have suggested that lens capsular violation by a foreign body is an indication for immediate lens removal. Sometimes, however, the resultant lens opacity may remain localized without visual compromise. The authors report a series of patients who had lens capsular disruption from an intraocular foreign body that resulted in visually insignificant lens opacities.

A series of five patients with lens capsular disruption as a result of an intraocular foreign body injury were reviewed retrospectively.

All five patients had lens injury from a small foreign body in a peripheral lenticular location. In three patients the foreign body was intralenticular, whereas in the other two patients the foreign body transversed the lens and was located in the posterior segment. In two patients, the foreign body was not removed. Three of the patients required pars plana vitrectomy. In all patients, final visual acuity was at least 20/40, and the lenticular opacity remained localized to an eccentric location.

A progressive, visually significant cataract is not the inevitable result of lens injury by an intraocular foreign body. When indicated, surgical removal of the foreign body may be attempted using a lens-sparing procedure.