FEB 22, 2022
Corneal Burn During Phacoemulsification Using Healon 5 in an Acute Angle Closure Glaucoma Eye: Its Causation and Management
AAO2021 Video Program
Cataract/Anterior Segment, Complications, New Technology and Instruments
Purpose To understand why a corneal burn occurred in an eye with a shallow anterior chamber with the use of Healon 5 and subsequent management of the wound leak. Methods Video demonstrating the build up to and the occurrence of the corneal burn. Wound repair using cyanoacrylate glue. Results Analysis of the video shows that the factors contributing to the adverse event were as follows: (1) The viscoelastic was not adequately aspirated prior to sculpting, (2) a stream of bubbles was seen within the sleeve during phacoemulsification and (3) phaco power was not in linear mode and was delivering full power. Wound leak despite suturing, at the end of the procedure, was addressed by the use of cyanoacrylate glue to seal the wound. Conclusion Similar incidents in eyes with a shallow anterior chamber must be prevented by actively removing the visco-adaptive/cohesive viscoelastic by irrigation and aspiration and replacing it with a dispersive viscoelastic to ensure that free flow of balanced salt solution is established within the sleeve prior to the start of phacoemulsification.