Quantitative Assessment of Anterior Chamber Inflammation in Patients with Retained Presumed Intraocular Cotton Fiber after Phacoemulsification

Bakbak, Berker; Gedik, Şansal; Öztürk, Bayram; Köktekir, Bengü Ekinci; Gonul, Saban; Yılmaz, Mevlüt

doi:10.3109/09273948.2013.766216

Cited by 12 publications

(6 citation statements)

References 10 publications

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“…11 A small prospective controlled study of 14 patients with retained presumed cotton fibers following phacoemulsification surgery showed no increase in anterior chamber inflammation in these cases. 8 The inert nature of the intraocular cotton fibers was confirmed in a retrospective review of 19 patients with a mean follow-up of 42 months. 7 Metallic foreign bodies from a phacoemulsification tip (titanium with anodized surface) were also shown to be inert within the anterior chamber.…”

Section: Discussionmentioning

confidence: 97%

“…1 Retained intraocular foreign bodies after cataract surgery are rare, with few documented reports in the literature. [2][3][4][5][6][7][8][9][10][11][12] We report an exceptionally rare complication following seemingly routine cataract surgery. It highlights the importance of an index of suspicion for retained intraocular foreign bodies when a patient presents with inflammation in the operated eye.…”

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confidence: 99%

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Rare complication following cataract surgery

Cornish

Lim-Fat

Greiner

2014

Journal of Cataract and Refractive Surgery Online Case Reports

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We report a rare complication in which a foreign body was inadvertently left in the eye and the patient presented with a chronic red and sore eye. The foreign body was identified as a surgical needle in the superior anterior chamber, emerging from the conjunctiva superior to the limbus. The needle was removed surgically followed by a vitrectomy and removal of the dislocated intraocular lens. The patient has done well. Careful examination should be done and retained foreign bodies considered a differential diagnosis when patients present following surgery, especially when details of the surgery are missing.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. JCRS Online Case Reports 2014; 2:71-72 Q 2014 ASCRS and ESCRSCataract surgery is the most common intraocular surgical procedure and has a low risk for complications. 1 Retained intraocular foreign bodies after cataract surgery are rare, with few documented reports in the literature. [2][3][4][5][6][7][8][9][10][11][12] We report an exceptionally rare complication following seemingly routine cataract surgery. It highlights the importance of an index of suspicion for retained intraocular foreign bodies when a patient presents with inflammation in the operated eye. CASE REPORTA 72-year-old man was referred to our emergency clinic with a sore, red left eye. Cataract surgery had been performed elsewhere in that eye 5 months previously, but no surgical details were available. The right eye was unremarkable. Visual acuity was 6/6 and counting fingers (CF) in the right eye and left eye, respectively. On examination, the left eye had marked conjunctival injection, corneal edema, and inflammation in the anterior chamber. There was also a large superior iridectomy with superior displacement of the pupil, a dislocated intraocular lens (IOL) in the inferior vitreous, and a retained foreign body identified as a surgical needle in the superior anterior chamber (Figure 1, A) and emerging from the conjunctiva superior to the limbus (Figure 1, B). There was no attached suture.Surgery was performed. The conjunctiva around the needle area was opened, and the needle gently pulled out. A complete pars plana vitrectomy was performed, and the dislocated rigid poly(methyl methacrylate) IOL was removed. The corneal wound was closed with 10-0 nylon sutures. Intravitreal antibiotics were used prophylactically. The patient was left aphakic. At 4 months follow-up, the eye was quiet with a visual acuity of CF and a flat retina. Old keratic precipitates were present in the otherwise quiet eye. Macular edema was diagnosed and treated effectively with a tapered regimen of oral prednisolone starting at 40 mg daily. The visual acuity subsequently improved to 6/36 with aphakic correction. A secondary IOL implantation and pupilloplasty are planned.

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Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

Rare complication following cataract surgery

Cornish

Lim-Fat

Greiner

2014

Journal of Cataract and Refractive Surgery Online Case Reports

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“…Foreign materials include presumed cotton fibres, small metallic and plastic particles, cilia, or microstructures of unknown material [1]. Cotton fibres previously seemed to have been a relatively frequent postoperative finding after cataract surgery occurring in 1.7 to 6.4 % of all eyes [2,3]. The removal of cotton products like gauze and swabs from surgical trays and the substitution of cotton clothes by new disposable textiles consisting of polymeric plastic materials has obviously led to a decrease of intraocular delivery of cotton fibres.…”

Section: Discussionmentioning

confidence: 99%

Microfibres in the Capsular Bag after Cataract Surgery

Gerding¹

2022

Klin Monbl Augenheilkd

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“…[6,18,19] The presence of extraneous materials in the anterior chamber may elicit severe inflammatory reactions and lead to grave consequences to the eye. [7,20] Toxic anterior segment syndrome (TASS) is an acute sterile anterior chamber inflammatory reaction, usually developing between 12 and 48 h after surgery, [21][22][23] though late-onset TASS has also been reported. [24] It is a devastating complication of intraocular surgery.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the presence of contaminants or toxic/irritant substances on the ocular surface is a safety hazard, posing a risk of postoperative infection and inflammation should they gain access into the anterior chamber. [4][5][6][7] Ensuring a hydrated cornea and a clean ocular surface free of unwanted material is essential to address these issues and achieve perfect anterior segment visualisation during cataract surgery.…”

Section: Introductionmentioning

confidence: 99%

The eye wash technique: A simple and effective technique for intraoperative ocular surface lavage

Rosatelli

2022

GJCSRO

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Objectives: The author proposes an extremely effective and practical method of ocular surface hydrating and cleaning during anterior segment surgery, the Eye Wash Technique (EWT), in substitution for the traditional methods employing a syringe and cannula for ocular irrigation. Materials and Methods: The EWT utilizes the intraocular irrigating solution (IS) used in the surgery. It is performed by employing the irrigating line of the phacoemulsification (phaco) machine or the irrigating fluid IV drip in case of manual cataract surgery. The eye irrigation is performed directly from the Luer end attachment of these irrigating lines, which is positioned above the inner cantus pointing to the globe’s nasal limbal region. With the phaco machine pedal in position 1 (irrigation only) or in panel continuous irrigation mode in case of phaco surgery, or by opening the roller clamp of the IV drip line in case of manual surgery, IS flow ensues and is directed to the eye from a nasal direction to provide a steady flow to wash the exposed eye surface as well as the lid margins and lid speculum. The irrigation is maintained for two to five seconds with side-to-side jiggling if needed, to ensure complete ocular surface coverage. Cornea hydration is achieved and any unwanted material on the ocular surface is washed out. Results: The EWT was easily incorporated into the surgical routine with no difficulty in adaptation to the technique or in its employment. The surgical time was not prolonged when employing the technique. The EWT effectively provided both corneal hydration and ocular surface cleaning every time it was used, with no need to resort to the traditional syringe and cannula irrigation method at any time. Conclusion: The EWT should be incorporated into the anterior segment surgical routine and performed at the beginning of surgery, before inserting the intraocular lens, and at the end of the surgery; also, at any time during surgery should the need arise, enhancing anterior segment surgical visualization and safety.

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Quantitative Assessment of Anterior Chamber Inflammation in Patients with Retained Presumed Intraocular Cotton Fiber after Phacoemulsification

Cited by 12 publications

References 10 publications

Rare complication following cataract surgery

Rare complication following cataract surgery

Microfibres in the Capsular Bag after Cataract Surgery

The eye wash technique: A simple and effective technique for intraoperative ocular surface lavage

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