Occult anterior-chamber metallic fragment post-phacoemulsification masquerading as chronic recalcitrant postoperative inflammation.
OBJECTIVE
To report a case of an occult, metallic, anterior-chamber intraocular foreign body after uneventful phacoemulsification that was masquerading as chronic recalcitrant postoperative inflammation.


METHODS
Interventional case report.


METHODS
A 73-year-old patient was referred to us for recalcitrant anterior-chamber inflammation after uneventful phacoemulsification; the patient presented with visual disturbances, anterior-chamber inflammation, and macular epiretinal membrane with concomitant cystoid macular edema.


RESULTS
After meticulous evaluations and repeated clinical examinations, a metallic intraocular foreign body was discovered on the iris, which was surgically removed and analyzed. Chemical analysis revealed copper, aluminum, and zinc. Pars plana vitrectomy with epiretinal membrane and indocyanine-green-assisted internal limiting membrane peeling followed, with subsequent improvement of visual acuity.


CONCLUSIONS
Intraocular foreign bodies should always be considered in the differential diagnosis of recalcitrant inflammation post-phacoemulsification. However, in the absence of intraocular inflammation, surgical removal of such particles is questionable.
Stangos
Alexandros N
AN
Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland. astangos@hotmail.com
Pournaras
Constantin J
CJ
Petropoulos
Ioannis K
IK
D000368:Aged; D000867:Anterior Chamber / Q000473:pathology*; D002908:Chronic Disease; D004396:Coloring Agents; D003937:Diagnosis, Differential; D019773:Epiretinal Membrane / Q000150:complications / Q000601:surgery; D005129:Eye Foreign Bodies / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D007498:Iris / Q000293:injuries* / Q000601:surgery; D008269:Macular Edema / Q000150:complications / Q000601:surgery; D008670:Metals; D018918:Phacoemulsification; D011183:Postoperative Complications; D041623:Tomography, Optical Coherence; D014606:Uveitis, Anterior / Q000175:diagnosis* / Q000601:surgery; D014792:Visual Acuity; D014821:Vitrectomy
D004396:Coloring Agents; D008670:Metals; D007208:Indocyanine Green