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Descemet's tear due to injector cartridge tip deformity.

Biswas P, Sengupta S, Paul A, Kochgaway L, Biswas S - Indian J Ophthalmol (2012 May-Jun)

Bottom Line: In our reported case, a Sensar AR40e IOL (Abbott Medical Optics, USA) was loaded into Emerald C cartridge, outside the view of the operating microscope, by the first assistant.Gross downward beaking of the bevelled anterior end of the cartridge was subsequently noticed upon examination under the microscope.We suggest careful preoperative microscopic inspection of all instruments and devices entering the patient's eyes to ensure maximum safety to the patient.

View Article: PubMed Central - PubMed

Affiliation: B B Eye Foundation, 2/5, Sarat Bose Road, Kolkata, India.

ABSTRACT
Foldable intraocular lens (IOL) implantation using an injector system through 2.8-mm clear corneal incision following phacoemulsification provides excellent speedy postoperative recovery. In our reported case, a Sensar AR40e IOL (Abbott Medical Optics, USA) was loaded into Emerald C cartridge, outside the view of the operating microscope, by the first assistant. The surgeon proceeded with the IOL injection through a 2.8-mm clear corneal incision after uneventful phacoemulsification, immediately following which he noted a Descemet's tear with a rolled out flap of about 2 mm near the incision site. Gross downward beaking of the bevelled anterior end of the cartridge was subsequently noticed upon examination under the microscope. We suggest careful preoperative microscopic inspection of all instruments and devices entering the patient's eyes to ensure maximum safety to the patient.

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Related in: MedlinePlus

A small rolled out Descemet's flap and adjacent Descemet's striae (left eye of the reported case on the first postoperative day)
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Figure 2: A small rolled out Descemet's flap and adjacent Descemet's striae (left eye of the reported case on the first postoperative day)

Mentions: On the first postoperative day, the patient's LE had an uncorrected VA of 20/60 with a small rolled out Descemet's flap and adjacent Descemet's striae at the site of the main clear corneal incision (temporally) [Fig. 2] with mild corneal edema. The edema persisted at 7 days post-op with mild resolution. However, the rolled out flap was not evident any more. A corneal opacity remained at the deeper corneal layers with mild surrounding edema, even at the time of last check-up at 4 weeks post-op, with a BCVA of 20/30 [Fig. 3]. The corneal endothelial cell count 4 weeks after surgery was 2332/mm2.


Descemet's tear due to injector cartridge tip deformity.

Biswas P, Sengupta S, Paul A, Kochgaway L, Biswas S - Indian J Ophthalmol (2012 May-Jun)

A small rolled out Descemet's flap and adjacent Descemet's striae (left eye of the reported case on the first postoperative day)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3361820&req=5

Figure 2: A small rolled out Descemet's flap and adjacent Descemet's striae (left eye of the reported case on the first postoperative day)
Mentions: On the first postoperative day, the patient's LE had an uncorrected VA of 20/60 with a small rolled out Descemet's flap and adjacent Descemet's striae at the site of the main clear corneal incision (temporally) [Fig. 2] with mild corneal edema. The edema persisted at 7 days post-op with mild resolution. However, the rolled out flap was not evident any more. A corneal opacity remained at the deeper corneal layers with mild surrounding edema, even at the time of last check-up at 4 weeks post-op, with a BCVA of 20/30 [Fig. 3]. The corneal endothelial cell count 4 weeks after surgery was 2332/mm2.

Bottom Line: In our reported case, a Sensar AR40e IOL (Abbott Medical Optics, USA) was loaded into Emerald C cartridge, outside the view of the operating microscope, by the first assistant.Gross downward beaking of the bevelled anterior end of the cartridge was subsequently noticed upon examination under the microscope.We suggest careful preoperative microscopic inspection of all instruments and devices entering the patient's eyes to ensure maximum safety to the patient.

View Article: PubMed Central - PubMed

Affiliation: B B Eye Foundation, 2/5, Sarat Bose Road, Kolkata, India.

ABSTRACT
Foldable intraocular lens (IOL) implantation using an injector system through 2.8-mm clear corneal incision following phacoemulsification provides excellent speedy postoperative recovery. In our reported case, a Sensar AR40e IOL (Abbott Medical Optics, USA) was loaded into Emerald C cartridge, outside the view of the operating microscope, by the first assistant. The surgeon proceeded with the IOL injection through a 2.8-mm clear corneal incision after uneventful phacoemulsification, immediately following which he noted a Descemet's tear with a rolled out flap of about 2 mm near the incision site. Gross downward beaking of the bevelled anterior end of the cartridge was subsequently noticed upon examination under the microscope. We suggest careful preoperative microscopic inspection of all instruments and devices entering the patient's eyes to ensure maximum safety to the patient.

Show MeSH
Related in: MedlinePlus