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Transocular removal of a retrobulbar foreign body and internal patch of the posterior exit wound with autologous tenon capsule.

A case of perforating ocular injury with a retrobulbar foreign body and a large full-thickness posterior pole defect near the optic disc was scheduled for vitrectomy after primary corneal suturing. Because it was difficult to remove the retrobulbar foreign body by orbitotomy and perform the outside suture, the retrobulbar foreign body was removed through the posterior hole by a transocular approach, and an autologous Tenon capsule flap was used to internally patch the large full-thickness posterior pole defect, thus enabling silicon tamponade. After 3 months of follow-up, there was no immune response around the patch. The retina remained mostly attached with a maintained peripheral visual field, normal intraocular pressure, and good cosmetic appearance. This surgical technique may be valuable in patients with a perforating retrobulbar foreign body and a large full-thickness posterior pole defect.