Femtosecond laser and magnet-assisted removal of an intralenticular metallic foreign body with trifocal intraocular lens implantation

Penetrating ocular injuries with retained intraocular foreign bodies (FBs) are vision-threatening emergencies. Metallic FBs are the most common, whereas isolated intralenticular FBs are uncommon and pose unique surgical challenges. We report a 43-year-old man who presented with diminished vision following a penetrating ocular injury and was found to have a metallic intralenticular FB embedded within the crystalline lens. Anterior segment imaging and intraoperative optical coherence tomography confirmed its location away from the posterior capsule. Femtosecond laser–assisted cataract surgery was performed using precautions similar to those for posterior polar cataract. The femtosecond-created fragmentation plane enabled controlled access, allowing atraumatic removal of the FB with an intraocular magnet. Cataract extraction was completed uneventfully, followed by trifocal intraocular lens implantation. At 6 weeks, the patient achieved an uncorrected visual acuity of 6/6 for distance and N6 for near. This technique enabled safe removal with excellent visual rehabilitation.