Intraocular ophthalmic ointment following clear corneal phacoemulsification: Clinical implications

Abstract

We report 4 cases of apparent ophthalmic ointment in the anterior chamber after sutureless clear corneal phacoemulsification and posterior chamber intraocular lens implantation. The cases, as well as previous literature, indicate that ointment for topical use can be well tolerated in the eye, although glaucoma and uveitis can be potential negative outcomes. Possible risk factors, some of which may be related to current rates of endophthalmitis after clear corneal cataract surgery, and methods to prevent intraocular ophthalmic ointment after cataract surgery are discussed.

Optical Coherence Tomography Findings in Anterior Chamber Ointment Globule after Phacoemulsification

“…Retained cilia, metallic fragments, and ointments (chloramphenicol or tobramycin-dexamethasone) are rare occurrences in phacoemulsification today [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. Ophthalmic ointments are typically prepared in white petrolatum, parahydrobenzoic acids (parabens), mineral oils, or in a combination of these.…”

“…The decision to remove an ointment globule surgically is controversial and must be based on the individual clinical examination. While on the one hand, a larger part of the literature has confirmed the benign nature of ointments [ 3 ], other reports have pointed out ocular hazards [ 2 ]. We present optical coherence tomography (OCT) findings of constant corneal touch and evidence of endothelial loss in the eye with the globule.…”

A Japanese Survey of Perioperative Antibiotic Prophylaxis in Cataract Surgery

“…However, the concentration of an ophthalmic ointment in the anterior chamber at 1 hour after administration is only 219 ng/mL. 11,12 Although early self-administration of eyedrops is very safe, there are latent risks such as postoperative infection that can occur when inexperienced patients remove their eye patch and administer the eyedrops. 5 Therefore, ophthalmic ointments appear to have little effect on intraoperative infections.…”

Critical appraisal of loteprednol ointment, gel, and suspension in the treatment of postoperative inflammation and pain following ocular and corneal transplant surgery

“…Teaching patients or companions how to apply the ointment is also time-consuming, and doctors vary in how they have patients apply the medication. Additionally, there is a concern about the inadvertent entrance of the ointment into the anterior chamber 48. Optimal care must be taken to have a watertight closure of the incision sites and to instruct the patients to not rub their eyes in cases where LE ointment is considered following the surgery 49.…”