We present the case of a 74-year-old Caucasian female who suffered sudden visual loss after routine phacoemulsification cataract surgery. The patient was subsequently diagnosed with nonarteritic anterior ischaemic optic neuropathy. The case is described in detail, and a concise review of the literature is presented together with the authors' view on the subject outlined. This is a very rare complication after cataract surgery even in high-risk patients with associated systemic comorbidities. We suspect that the previous history of obesity, coronary artery disease, and arteriosclerosis contributed to the development of this serious ocular complication. We suggest appropriate measures to reduce the risk of its occurrence. ARTICLE HISTORY

Purpose:To compare outcomes and complications of patients undergoing phacoemulsification with and without the administration of intracameral phenylephrine.Materials and Methods:In this retrospective study, a chart review was performed. Two groups with an equal number of patients who did or did not receive intracameral phenylephrine during phacoemulsification were compared for differences in outcomes, risk factors and complications. The Chi-square test was used for comparison between groups. P<0.05 was statistically significant.Results:The two groups were well matched with regard to preoperative ophthalmic and systemic risk factors for complications and had very similar phacoemulsification power and time profiles. No differences in outcome were detected (P>0.05, all comparisons).Conclusion:This retrospective study suggests that intracameral phenylephrine normalizes the intraoperative risk of small pupil cataract surgery and is not associated with an increased risk of systemic or postoperative ophthalmic complications.