I bet he/she had an intravitreal injection with inadvertent stick of the equatorial lens capsule that led to lens material leaking out (following the needle track as it withdrew) that later "solidified" and, given it's location, trapped liberated pigment from the IPE / ciliary processes (pigment could also have been incarcerated within the lens at the time of the needle stick). Consider the following: no history of trauma; locations = superior temporal quadrant AND in farrr periphery of the lens; it sucked down the phaco no problem. Furthermore, the fact that the surgeon didn't remove it with forceps makes me suspicious that he/she knew it was lens material as opposed to a fb...The patient may not recall any procedure having been done before, but I see pt's all the time that tell me they've never had CE, meanwhile I'm staring at their PCIOL 😆. Also- it would have been difficult for a fb to have flown into the eye thru the sclera in the STQ like this bc it's often covered by the eyelid...In any case, that's my 2 cents
So much to unpack What a lucky surgeon I wouldn’t hydro dissect, rotate Would have pulled it out with forceps waaaaaaaaay sooner Intracameral Abx The FB kept dancing around in the AC for too long Post cap spared , but I don’t know how the endothelium fared
I bet he/she had an intravitreal injection with inadvertent stick of the equatorial lens capsule that led to lens material leaking out (following the needle track as it withdrew) that later "solidified" and, given it's location, trapped liberated pigment from the IPE / ciliary processes (pigment could also have been incarcerated within the lens at the time of the needle stick). Consider the following: no history of trauma; locations = superior temporal quadrant AND in farrr periphery of the lens; it sucked down the phaco no problem. Furthermore, the fact that the surgeon didn't remove it with forceps makes me suspicious that he/she knew it was lens material as opposed to a fb...The patient may not recall any procedure having been done before, but I see pt's all the time that tell me they've never had CE, meanwhile I'm staring at their PCIOL 😆. Also- it would have been difficult for a fb to have flown into the eye thru the sclera in the STQ like this bc it's often covered by the eyelid...In any case, that's my 2 cents
Brilliant. I love the theory and it seems quite likely.
Wow, great interpretation 👏
I would insert IOL under the lens fragment before.
Great!. I prefer to remove IOFB with forceps as soon as possible during phaco.
It's a perfect example
Thanks.
Great case, thank you !!!
So much to unpack
What a lucky surgeon
I wouldn’t hydro dissect, rotate
Would have pulled it out with forceps waaaaaaaaay sooner
Intracameral Abx
The FB kept dancing around in the AC for too long
Post cap spared , but I don’t know how the endothelium fared
Dangerous manoeuvres for the capsule and endothelium . The foreign body should have been removed with a forceps.