A NEW MULTIFUNCTIONAL EXPANDABLE MEMORY LOOP DEVICE

Eckardt Forceps Tip Widening for the Removal of Posterior Intraocular Foreign Bodies Bigger Than 1 mm

PURPOSE

To propose a new technique with an "old" tool to allow for better intraocular foreign body (IOFB) grasping and manipulation during mininvasive vitreoretinal surgery.

METHODS

The authors report herein their technique on seven eyes, diagnosed with posterior IOFBs, in which the surgery consisted of a 23-gauge vitrectomy, using, for IOFB grasping, a Grieshaber DSP 23-gauge Eckardt forceps, properly modified intraoperatively. Such result was achieved by enlarging the forceps opening bite, according to the IOFB size.

RESULTS

In all patients, IOFBs were removed using the modified 23-gauge Grieshaber Eckardt forceps. In 6 cases, a combined phacovitrectomy was performed, and the IOFB expressed through the corneal phacoincision; in one phakic patient, the removal was performed through the sclerotomy, extended just as needed.

CONCLUSION

The Grieshaber Eckardt forceps commonly used in MIVS can be used in IOFB surgery for a scleral or corneal removal. In case of IOFB bigger than 1 mm, enlarging the forceps bite according the IOFB size provides a firm and safe grip, allowing the surgeon to complete the surgery without switching to bigger and more traumatic instrumentation, reducing collateral damage and shortening the surgery time.

The claw: A novel intraocular foreign body removal forceps

Removal of intraocular foreign body (IOFB) from the posterior segment of the eye is challenging. In addition to surgical skill, it requires specific instrumentation to grasp and remove the IOFB. Small metallic IOFB can be removed using intraocular rare earth magnets but metallic IOFB larger than 3 mm and nonmetallic IOFBs like shot gun pellets, stones, or large glass fragments require specialized IOFB grasping forceps for removal. We describe the design and case-based clinical applications of a novel IOFB removal forceps, "the claw" that consists of a titanium handle and a 27-mm, 19-G metallic shaft that houses four retractable prongs made of nitinol wire. When completely extended, the prongs measure 14 mm in length and open up to 8-8.5 mm in the widest extent. The four prongs offer a very secure grip without crushing or splintering the IOFB leading to minimal chances of IOFB slippage and inadvertent retinal trauma.