J Korean Ophthalmol Soc.  2014 Mar;55(3):454-458. 10.3341/jkos.2014.55.3.454.

A Case of Corneal Burn During Phacoemulsification

• Lee HS
• Lee TH
• Yoon KC

• KMID: 2218279
• DOI: http://doi.org/10.3341/jkos.2014.55.3.454

Abstract

PURPOSE
To report a case of severe corneal burn during phacoemulsification that was successfully managed with a second operation and medical treatment.
CASE SUMMARY
An 89-year-old female had phacoemulsification of a mature cataract in her right eye, and was transferred to our outpatient clinic after development of a thermal burn at the corneal incision site. On initial examination, visual acuity was light perception and slit-lamp examination revealed diffuse, severe corneal edema, and a 3.0 x 3.0 mm-sized epithelial defect with severe stromal opacity around the incision site. Extracapsular cataract extraction through superior scleral incision was performed with posterior chamber implantation of a 3-piece hydrophobic acrylic intraocular lens (IOL). Topical steroids as well as hypertonic saline were used to manage corneal edema postoperatively. One month postoperatively, her best corrected visual acuity was 0.06 and slit-lamp examination showed markedly decreased corneal edema and epithelial defect. Three months postoperatively, her best corrected visual acuity was 0.2, the IOL was centered in the capsular bag, and corneal edema nearly disappeared with remnant moderate corneal opacities.
CONCLUSIONS
We report successful treatment of severe corneal burn during phacoemulsification managed with extracapsular cataract extraction through scleral incision and medical treatment.

Keyword

Corneal burn; Extracapsular cataract extraction; Phacoburn; Phacoemulsification

MeSH Terms

Aged, 80 and over
Ambulatory Care Facilities
Burns*
Cataract
Cataract Extraction
Corneal Edema
Corneal Opacity
Female
Humans
Lenses, Intraocular
Phacoemulsification*
Steroids
Visual Acuity
Steroids

Figure

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  Figure 1. Slit lamp photograph (A) and anterior segment optical coherence tomography (B) of an 89-year-old woman with thermal burn of the temporal cornea (white arrow).

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  Figure 2. Intraoperative findings showing superior scleral incision (A), lens extraction with lens spoon (B), bimanual irrigation and aspiration technique removing remnant cortex (C), and implantation of 3 piece acrylic intraocular lens.

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  Figure 3. Slit lamp photographs and anterior segment optical coherence tomography at postoperative 1 month (A, C) and 3 months (B, D) showing a gradual decrease of epithelial defects and stromal edema.

Reference

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