[The surprising finding and removal of a large plastic foreign body through the corneal wound from the vitreous cavity with good outcome].

Background: Presented is a patient whose history showed that during a hammer-blow on a piece of iron something had flown into his left eye. Clinical investigation revealed a 9-mm long, horizontal, paracentrally located, penetrating corneal wound. Temporally in the same region the iris was torn in its entire width. The lens appeared opaque and seemed to be cut in two parts. Radiological investigation revealed no foreign body.

Methods: The operative treatment presented a surprise: the white piece, which had been considered to be a part of the traumatic cataract, was actually the edge of a large plastic foreign body lying in the vitreous cavity. The exciting and complicated procedure of removing this 12 x 9 x 2 mm large foreign body through the corneal wound as well as the reconstruction of the anterior segment of the eye are demonstrated.

Results: Seven months after the injury the corneal wound is very tender, the corneal sutures have not been removed, and the retina of the aphakic eye is undamaged. Visual acuity with a contact lens is 0.6 - 0.7.

Conclusions: Operative treatment of patients with a penetrating eye injury is always demanding and difficult and requires a lot of experience. Particularly in apparently hopeless cases, an optimum primary care is of greatest importance.