We wish to thank Dr Cannava for bringing up one of the procedures that we discussed when planning the surgery for our patient. We have, in fact, had the opportunity of using metal cutters to cut single hooks in similar situations with excellent results. The main difficulty in this case was the fact that this was a triple hook that, because of the depth, did not allow for any clearance between the eyelid and the origin of the embedded hook itself. To be able to reach the hook it would have been necessary to exert substantial force on the lid and the hook with possible further damage to the cornea and globe ensuing. Because we were unable to determine the exact location of the fishhook in the globe preoperatively, we elected to do what in our opinion constituted the least traumatic manipulation of the globe, lid, and hook. Carefully splitting the eyelid fulfilled this requirement with no movement exerted on the hook. Once the hook is removed, repairing the lid is a simple procedure for any ophthalmologist with oculoplastic experience.
Maus M, Deramo VA, Cohen E, Jeffers J. Fishhook Removals. Arch Ophthalmol. 1999;117(12):1668-1669. doi: