J Korean Ophthalmol Soc.  2019 May;60(5):496-500. 10.3341/jkos.2019.60.5.496.

A Removed Chestnut Thorn after Corneal Incision

• Suh SY
• Kim SI
• Lee JE

• KMID: 2445146
• DOI: http://doi.org/10.3341/jkos.2019.60.5.496

Abstract

PURPOSE
To report the surgical technique to remove a chestnut thorn through a corneal incision.
CASE SUMMARY
A 54-year-old female visited our clinic complaining of a sudden foreign body sensation and conjunctival injection in her left eye after picking chestnuts 4 days prior to her visit. Visual acuity of both eyes was 1.0 and the intraocular pressures were within normal limits. Slit lamp examination revealed that a chestnut thorn had deeply penetrated the left corneal stroma and a small number of inflammatory cells were observed in the anterior chamber. There was no corneal defect stained with fluorescein and the Seidel test was negative. A corneal foreign body comprised of a chestnut thorn and its remnants was diagnosed and emergency surgery was performed. A partial corneal incision was made along the foreign body and the exposed foreign body was easily and completely removed. The patient was treated with topical antibiotics after surgery and no complication was observed during a follow-up period of 3 months.
CONCLUSIONS
In the case of a corneal foreign body comprised of a chestnut thorn, the foreign body with its remnants were easily removed by performing a partial corneal incision.

Keyword

Corneal trauma; Eye foreign body; Thorn

MeSH Terms

Anterior Chamber
Anti-Bacterial Agents
Corneal Injuries
Corneal Stroma
Emergencies
Eye Foreign Bodies
Female
Fluorescein
Follow-Up Studies
Foreign Bodies
Humans
Intraocular Pressure
Middle Aged
Sensation
Slit Lamp
Visual Acuity
Anti-Bacterial Agents
Fluorescein

Figure

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  Figure 1 Slit-lamp ophthalmoscopic findings at initial visit. Chestnut thorn penetrated the cornea.

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  Figure 2 Anterior segment optical coherence tomography at initial visit. The chestnut thorn penetrated the cornea deep into the Descemet's membrane.

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  Figure 3 Surgical procedure to remove chestnut thorn through the corneal incision. (A) Schematic image of removing foreign body from the cornea. The foreign body was deeply embedded into the corneal stroma, and a partial corneal incision was made along the foreign body. (B) After corneal incision, the deepest part of the foreign body was reversely pushed to the outside of the cornea with the knife.

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  Figure 4 Slit-lamp findings of cornea at 3 months after the surgery. Mild stromal opacity was remained at the previous foreign body site.

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