A user facility in france reported that during cataract surgery there was no irrigation which led to overheating and a corneal burn.Beforehand a test was performed by an intern surgeon, who initiated the continuous irrigation outside the eye which was functional.After approximately 30 seconds of the sculpting phase (4-5 movements to carve out the main groove), the chamber collapsed, and the surgeon noticed coagulation of the crystalline proteins (white eye).Immediately, the phaco was removed and it was noticed that no irrigation was present, the tip was warm and that there was an incision burn.The surgeon continued the surgery by changing the cassette, all the tubing and the phaco tip, while abundantly irrigating the incision with cold saline solution.The incision was very difficult to close, requiring two stitches of monofilament without the possibility of a complete water tightness.The surgeon also injected a viscous solution into the incision to try to seal it better.The post-surgery anti-inflammatory medication was increased to 6 doses of tobradex (tobramycine and dexamethason) eye drops, per day and a contact lens dressing was applied.The surgery time was increased by 10-15 minutes.On day two post-op, the patient was airtight, however the visual acuity remained low (around 1/10 compared with 6/10 preop), due to significant corneal astigmatism (partly related to the sutures and partly to the corneal scar, which was irreducible according to the surgeon).Moreover, the patient presented descemet folds, as a result of the heating, which also contributed to the drop in visual acuity.The patient also suffers from bilateral exudative amd treated with antivegf, which has led to a loss of function in the contralateral eye (right eye), leaving her monophthalmic in the left eye where the incident occurred.
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