A novel technique of magnetically guided single-pass limbal extraction for intraocular foreign bodies: Eliminating the need for intraocular instrument relay.

PURPOSE: To prospectively evaluate the safety and efficacy of a novel surgical technique for removing metallic intraocular foreign bodies (IOFBs) in eyes with concomitant traumatic cataract, utilizing a magnetic probe introduced through a limbal incision to directly extract the IOFB in a single pass. METHODS: This prospective, interventional case series included 21 consecutive eyes of 21 patients presenting with posterior segment IOFBs and traumatic cataracts. The standardized procedure involved: primary phacoemulsification, creation of a central posterior capsulotomy (posterior vitrectorhexis), pars plana vitrectomy (PPV) to mobilize the IOFB, and introduction of a 19-gauge intraocular magnet through the main limbal corneal incision. The magnet was passed through the posterior capsulotomy to directly engage and remove the IOFB via the same limbal route. Main outcome measures were successful IOFB removal, incidence of intraoperative complications (particularly IOFB slippage and iatrogenic retinal injury), postoperative complications, and best-corrected visual acuity (BCVA). RESULTS: The novel technique was successfully performed in all 21 eyes (100%) without the need for intraocular instrument relay. The mean IOFB size was 3.5 ± 1.6 mm. No cases of intraoperative IOFB slippage or iatrogenic retinal injury occurred. Preoperatively, 17 eyes (81.0%) had a BCVA worse than 20/200. Postoperatively, 17 eyes (81.0%) achieved a BCVA of 20/40 or better. No cases of postoperative retinal detachment or endophthalmitis were observed. Transient macular edema and epiretinal membrane occurred in one case each (4.8%). CONCLUSION: The magnetically guided single-pass limbal extraction technique represents a safe, effective, and streamlined approach for removing IOFBs in the setting of traumatic cataract.