Intra-orbital knife blade foreign body: A case series

Objective. To describe cases of intra-orbital knife blade foreign body following stabs to the orbit, together with a novel technique for removal. Methods. Retrospective case series of 3 patients. Results. All 3 patients had knife blades embedded in the orbit as a result of assault. The blades assumed the same direction within the orbit with varying degrees of depth, one causing serious vascular injury. In 2 cases the globes were intact after foreign body removal, with good visual outcomes. The third patient required enucleation. Two of the 3 knife blades were removed using a 'double bone nibbler' technique. The third was embedded without a handle and required removal with minor manipulation of the globe. Conclusions. Thorough investigation for vascular injury must be done before any attempted surgical removal. Visual outcomes can be good after removal of a knife blade foreign body. The double bone nibbler technique is promising for the controlled removal of embedded blades that are rigidly fixed.