Metallic clip removal 40 years after scleral encircling surgery for retinal detachment: A case report.

Purpose: To report our findings in a case in which a metallic clip used for scleral encircling surgery was accidentally detected and surgically removed more than 40 years after its use in the initial retinal detachment surgery. Observations: The patient was a 54-year-old woman who had undergone surgical treatment for a rhegmatogenous retinal detachment in both eyes during childhood. Her preoperative decimal best-corrected visual acuity (BCVA) was 0.5 in the right eye and 0.01 in the left eye. Postoperatively, the BCVA improved to 1.0 in the right eye, but remained at 0.01 in the left eye. During follow-up period, the BCVA in the left eye improved to only 0.03. Due to the progression of a cataract, the BCVA in the left eye had been reduced to hand motion for more than 10 years and to light perception for the past 2 years. She sustained a mild head injury in a traffic accident and underwent plain skull radiography. A metallic-like foreign body was detected in the left orbit in the radiographs. The site of the foreign body corresponded to the site of a previous scleral encircling procedure. Although the patient was asymptomatic, the presence of the retained metallic implant raised concerns regarding magnetic resonance imaging safety and resulted in significant patient anxiety. Surgical exploration demonstrated that the metallic clip was partially located beneath the inferior rectus muscle and was encapsulated by fibrotic tissue. The clip, along with the associated silicone band, was successfully removed without intraoperative or postoperative complications. Conclusions and importance: This case underscores the long-term clinical and psychological implications of retained surgical materials from historical surgical procedures. Awareness of legacy implants and accurate documentation of surgical materials are essential to support safe, informed clinical decision-making in long-term postoperative care.