Main Article Content



  1. The management of penetrating ocular injury with IOFB and traumatic cataracts needs a thorough examination of the mechanism of injury, location, size, and composition of IOFB.

  2. Endophthalmitis, retinal detachment, and development of PVR are potentially vision-threatment.



Most IOFB are metallic and found in males of productive age as a consequence of work-related accidents. A 45-year-old man complained of sudden blurred vision in the left eye (3/60 pinhole 5/12) after getting hit by a foreign body when cutting grass with a lawn mower. Anterior segment examination revealed a 10 mm long, one-plane, straight, full thickness, already sutured inferonasal corneal laceration, inferonasal traumatic iridectomy size 3x7 mm, and opaque lens. Head CT-scan revealed opacity with metallic density intraocularly. Ultrasonography revealed an echogenic lesion, particle-shaped with 100% RCS complex density, located at the inferonasal of the vitreous cavity. Focal laser photocoagulation was performed preoperatively because there was a tear at the superonasal of the retina. The patient underwent cataract extraction, intraocular lens implantation, vitrectomy, and IOFB extraction in a one-step procedure. IOFB was found at the inferonasal side of a vitreous cavity with size 3 x 1 mm, metallic, and not attached to the retina. Silicon oil tamponade was used as a precaution because there were retinal tears. Postoperatively, the left eye's visualacuity was 5/20. After 6 months, the silicon oil was evacuated and the visual acuity became 5/8.5.


Penetrating ocular injury intraocular foreign body IOFB traumatic cataract vitrectomy IOFB extraction

Article Details

How to Cite
Putri, N. T., Firmansjah, M., & Prastyani, R. (2022). Penetrating Ocular Injury Management in Intraocular Foreign Body (IOFB) and Traumatic Cataract. Folia Medica Indonesiana, 58(3), 267–272.


  1. Abrams P, Birkhloz E, Tarantola R, et al (2011). Intraocular foreign body: A classic case of metal on metal eye injury. Available from Accessed March 6, 2022.
  2. Akpolat C, Evliyaoglu F, Kurt M, et al (2019). Traumatic cataract study: Surgical outcomes of blunt versus penetrating ocular injuries. Med. Sci. Int. Med. J. 8, 37–41.
  3. Al-Thowaibi A, Kumar M, Al-Matani I (2011). An overview of penetrating ocular trauma with retained intraocular foreign body. Saudi J. Ophthalmol. 25, 203–205.
  4. Babineau M, Sanchez L (2008). Ophthalmologic procedures in the emergency department. Emerg. Med. Clin. North Am. 26, 17–34.
  5. Bhagat N, Nagori S, Zarbin M (2011). Post-traumatic infectious endophthalmitis. Surv. Ophthalmol. 56, 214–251.
  6. Brar G, Ram J, Pandav S, et al (2001). Postoperative complications and visual results in uniocular pediatric traumatic cataract. Ophthalmic Surgery, Lasers Imaging Retin. 32, 233–238.
  7. Dakshayani D, Rakesh R (2014). Analysis of visual prognosis after surgery in traumatic cataract. J. Evid. Based Med. Healthc. 1, 1029–1046.
  8. Ehlers J, Kunimoto D, Ittoop S, et al (2008). Metallic intraocular foreign bodies: Characteristics, interventions, and prognostic factors for visual outcome and globe survival. Am. J. Ophthalmol. 146, 427–433.
  9. Erakgun T, Egrilmez S (2008). Prognostic factors in vitrectomy for posterior segment intraocular foreign bodies. J. Trauma Acute Care Surg. 64, 1034–1037.
  10. Gayton J, Sanders V, Karr M (2001). Pupillary capture of the optic in secondary piggyback implantation. J. Cataract Refract. Surg. 27, 1514–1515.
  11. Greven C, Collins A, Slusher M, et al (2002). Visual results, prognostic indicators, and posterior segment findings following surgery for cataract/ lens subluxation-dislocation secondary to ocular contusion injuries. Retina 22, 575–580.
  12. Kanski J, Bowling B (2016). Synopsis of clinical ophthalmology. Elsevier, Australia.
  13. Kanskii J (1989). Clinical ophthalmology: A systematic approach. Elsevier, China.
  14. Kavitha V, Balasubramanian P, Heralgi M (2016). Posterior iris fixated intraocular lens for pediatric traumatic cataract. Middle East African J. Phthalmology 23, 215–218.
  15. Knyazer B, Levy J, Rosen S, et al (2008). Prognostic factors in posterior open globe injuries (zone-III injuries). Clin. Experiment. Ophthalmol. 36, 836–841.
  16. Kuhn F, Mester V, Mann L, et al (2002). Eye injury epidemiology and prevention of ophthalmic injuries. In: Ocular Trauma: Principles and Practice. Thieme Medical Publishers, New York, pp. 14–20.
  17. Li L, Lu H, Ma K, Li Y-Y, Wang H-Y, Liu N-P. (2018).Etiologic Causes and Epidemiological Characteristics of Patients with Intraocular Foreign Bodies: Retrospective Analysis of 1340 Cases over Ten Years. J Ophthalmol.2018:1–8.
  18. Loncar L, Petric I (2004). Surgical treatment, clinical outcomes, and complications of traumatic cataract: Retrospective study. Croat. Med. J. 45, 310–313.
  19. Loporchio D, Mukkamala L, Gorukanti K, et al (2015). Intraocular foreign bodies: A review. Surv. Ophthalmol. 61, 582–596.
  20. Pandit K, Khatri A, Sitaula S, et al (2022). Panophthalmitis secondary to retained intraocular foreign body amidst a national lockdown during the COVID-19 pandemic: A case series and review of the literature. Ann. Med. Surg. 77, 1–8.
  21. Patel S, Langer P, Zarbin M, et al (2012). Diagnostic value of clinical examination and radiographic imaging in the identification of intraocular foreign bodies in open globe injury. Eur. J. Ophthalmol. 22, 259–268.
  22. Peters K, Meeker A, Williams L (2022). Endoscopic-assisted removal of intraocular foreign body embedded in the ciliary sulcus. Am. J. Ophthalmol. Case Reports 27, 1–3.
  23. Pieramici DJ, MacCumber MW, Humayun MU, Marsh MJ, de Juan E Jr. (1996).Open-globe injury. Update on types of injuries and visual results. Ophthalmology.103:1798–803.
  24. Platt A, Wajda B, Ingram A, et al (2017). Metallic intraocular foreign body as detected by magnetic resonance imaging without complications– A case report. Am. J. Ophthalmol. Case Reports 7, 76–79.
  25. Sarikkola A, Sen H, Uusitalo R, et al (2005). Traumatic cataracts and other adverse events with the implantable contact lens. J. Cataract Refract. Surg. 31, 11–24.
  26. Shah M, Shah S, Khandekar R (2008). Ocular injuries and visual status before and after their management in the tribal areas of Western India- A historical cohort study. Graefe’s Arch. Clin. Exp. Ophthalmol. 246, 191–197.
  27. Sternberg Jr P, de Juan Jr E, Michels R, et al (1984). Multivariate analysis of prognostic factors in penetrating ocular injuries. Am. J. Ophthalmol. 98, 467–472.
  28. Tian A, Ma H, Zhang R, et al (2017). Edaravone improves spatial memory and modulates endoplasmic reticulum stress-mediated apoptosis after abdominal surgery in mice. Exp. Ther. Med. 14, 355–360.
  29. Ugarte M, Osborne N, Brown L, et al (2013). Iron, zinc, and copper in retinal physiology and disease. Surv. Ophthalmol. 58, 585–609.
  30. Verma N, Ram J, Sukhija J, et al (2011). The outcome of in-the-bag implanted square edge polymethyl methacrylate intraocular lenses with and without primary posterior capsulotomy in pediatric traumatic cataract. Indian J. Ophthalmol. 59, 347–351.
  31. Wos M, Mirkiewicz-Sieradzka B (2004). Traumatic cataract--treatment results. Klin. Oczna 106, 31–34.
  32. Yeh S, Colyer M, Weichel E (2008). Current trends in the management of intraocular foreign bodies. Curr. Opin. Ophthalmol. 19, 225–233.
  33. Williams DF, Mieler WF, Abrams GW, Lewis H. (1988).Results and Prognostic Factors in Penetrating Ocular Injuries with Retained Intraocular Foreign Bodies. Ophthalmology.95:911–6.
  34. Yigit O (2012). Foreign body traumas of the eye are managed in an emergency department of a single institution. Turkish J. Trauma Emerg. Surg. 18, 75–79.
  35. Zaman M, Sofia I, Muhammad D (2006). Frequency and visual outcome of traumatic cataract. J. Postgrad. Med. Inst. 20, 330–334.
  36. Zhang Y, Zhang M, Jiang C, et al (2011). Intraocular foreign bnodies in China: clinical characteristics, prognostic factors, and visual outcomes in 1421 eyes. Am. J. Ophthalmol. 152, 66–73.