Novel Technique Used in Study of Facial Wounds

BY: .

Research by a Master of Medicine graduate examined knife wounds to the face and the removal of blades embedded in the eye.

The study was done by Dr Shaheer Ballim in the Department of Ophthalmology, who produced a thesis titled: “Intra-orbital knife-blade foreign body: A case series”.

The objective of Ballim’s study, supervised by Dr Linda Visser, was to describe cases of intra-orbital knife blade foreign body following stabs to the orbit, together with a new technique for removal. The orbit is the cavity in the skull in which the eye is situated. Foreign body refers to any object originating outside or intruding the body.

This was a retrospective case series of three patients who had knife blades embedded in the orbit as a result of assault. It was found that the blades assumed the same direction within the orbit of the patients, but with varying degrees of depth, with one causing serious vascular injury.

In two cases, the globes (eyeballs) were intact after foreign body removal, with good visual outcomes as a result. The third patient required enucleation which is the removal of the eye which leaves the eye muscles and remaining orbital contents intact.

Two of the three knife blades were removed using a “double bone nibbler” technique. The third patients orbit was embedded without a handle and required removal with minor manipulation of the globe. ‘It was found that thorough investigation for vascular injury must be done before any attempt to surgically remove the foreign object,’ said Ballim. ‘Visual outcomes can be good for the patient after the removal of the knife blade. The double bone nibbler technique proved promising for the controlled removal of embedded blades that were severely fixed.’

Ballim, an Ophthalmic surgeon, is currently in private practice at Parklands Hospital. ‘I think it is important to not doubt the value of one’s interesting clinical experiences. What may be considered by yourself as just part of your daily duties may actually be interesting publishable material.’

Ballim performs two sessional clinics: A Corneal ulcer clinic at St Aidan’s Hospital and the Keratoconus clinic at Inkosi Albert Luthuli Central Hospital.  Ballim spends most of his leisure time with his wife and two children.

-        Zakia Jeewa