Introduction Retained natural and foreign materials may be discovered in the anterior, middle and or posterior chambers of the eye following any penetrating injury or penetrating surgical procedure. Following cataract surgery, the commonly seen objects are retained remnants of uncollected lens material, however, cilia, suture material or other debris (a wisp of cotton from a used applicator) from the surgical field are plausible. Retained foreign material has the potential to produce both signs and/or symptoms through inflammatory induction via the object itself or allergens (flora/fauna) resting on the object. These reactions can be suppressed and eliminated by the effects of both the pre-operative and post-operative topical medical regimen (topical antibiotic, topical steroidal anti-inflammatory and topical non-steroidal anti-inflammatory). The ultimate management (removal or monitoring) is based on the personal experience of surgeon and the evolution of the clinical scenario. Case report A 64-year-old African American woman presented for her 1-month post-operative examination following cataract surgery, OD without signs or symptoms and good uncorrected vision. She had a retained intraocular foreign body in the anterior chamber: a cilium (presumably hers). Given the immune privileged nature of the anterior chamber there was a clear absence of inflammation. There was no indication of infection (endophthalmitis). Even with the possibility of anaphylactic or delayed hypersensitivity reactions, in the setting of presenting ophthalmic co-morbidities, the decision was made to educate the patient regarding the finding and adopt a strategy of monitoring the condition for signs and symptoms of beginning, evolving or worsening inflammation at 6-month intervals. Conclusion The literature recognizes that the incidence of retained intraocular foreign materials is rare. It supports the idea of observation; generating a working plan for removal based upon the individual experience and preference of the treating clinician as well as the trending clinical signs.
Gurwood et al. (Sun,) studied this question.