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Case Reports
. 2021 Feb;69(2):423-425.
doi: 10.4103/ijo.IJO_1161_20.

Endoscopic visualization-assisted corneal bee sting removal

Mudit Tyagi  1 , Subhakar Reddy  1 , Sayan Basu  2 , Rajeev R Pappuru  1 , Vivek P Dave  1
Affiliations
Case Reports

Endoscopic visualization-assisted corneal bee sting removal

Mudit Tyagi et al. Indian J Ophthalmol. 2021 Feb.

Abstract

Purpose: Deeply embedded corneal foreign bodies and intrastromal foreign body removal can often be a challenge. The aim of this report was to describe the utility of endoscopy in visualization and removal of an embedded corneal bee stinger.

Methods: A 44-year-old male patient developed toxic keratopathy after injury from a bee stinger. On examination, the bee stinger was noted to be deeply embedded in the corneal stroma. A superficial keratectomy was initially attempted; however, the stinger was noted to be intrastromal and protruding into the anterior chamber and could not be removed. An Endoscopy-assisted visualization was used to remove the stinger.

Results: The bee stinger was successfully removed and the patient's vision improved to 20/100 from an initial CFCF (counting fingers close to face) at time of presentation. At the end of 3 months follow-up, there was residual corneal edema along with cataractous changes in the lens as a sequelae of the initial bee sting injury. The patient subsequently underwent an endothelial keratoplasty along with phacoemulsification with intraocular lens implantation and the final BCVA improved to 20/40.

Conclusion: Endoscopyassisted visualisation of anterior chamber and angle structures can be valuable in removal of retained and deeply embedded corneal or intracameral foreign bodies.

Keywords: Bee sting injury; embedded corneal foreign body; endoscopy; toxic keratitis.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
(a) Diffuse slit-lamp photograph at initial presentation showing infiltrates at 7–8 o clock with diffuse descemets folds and corneal edema. An AS OCT examination revealed the presence of a protruding stinger (yellow arrow) from cornea into anterior chamber (1b) and epithelial bullous edema (blue arrow) (1c)
Figure 2
Figure 2
(2a, 2b) Console and probe of E4 laser and Endoscopy system (2c) Insertion of endoscopic probe at diametrically opposite end of embedded bee sting (2d) Endoscopic view of the stinger (yellow arrow). A serrated 23 G forceps was used for grasping the stinger and it was subsequently removed and delivered out. The removed stinger (yellow arrow) can be seen clearly in inset (2e). (2f) show endoscopy images of anterior chamber angle clearly delineating structures of the angle
See this image and copyright information in PMC

Comment in

  • Commentary: Corneal bee sting injury.
    Nair S, Kaur M, Titiyal JS. Nair S, et al. Indian J Ophthalmol. 2021 Feb;69(2):426-427. doi: 10.4103/ijo.IJO_2484_20. Indian J Ophthalmol. 2021. PMID: 33463603 Free PMC article. No abstract available.

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