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Study: Good visual outcomes possible in cases of inadvertent cannula release
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The inadvertent release of a cannula during cataract surgery or other anterior segment procedures is rare but can cause serious sight-threatening injuries, according to a study by researchers in Israel. However, the visual prognosis is good in most cases, unless the retina is disrupted, the study authors noted.
Shimon Rumelt, MD, and colleagues at the Western Galilee-Nahariya Medical Center, Nahariya, reviewed all cases of intraocular injuries stemming from the inadvertent release of an irrigation or viscoelastic cannula at their center over 15 years. During the period studied, 8,318 patients underwent cataract surgery, 1,490 received a corneal transplant or triple procedure and 422 underwent filtration surgery.
The researchers found that the unintentional release of a cannula occurred in nine of the 10,230 cases, for a incidence rate of 0.88 per 1,000 anterior segment surgeries annually. Of these nine cases, six occurred during cataract surgery and three occurred during either penetrating keratoplasty or corneal graft replacement, according to the study.
"The latter three cases included posterior capsule rupture and vitreous loss," the authors reported.
In most instances, the cannula release injured the iris or the anterior chamber angle without compromising postoperative vision. However, two of the nine cases sustained a macular scar, which was associated with a poor visual outcome — counting fingers at a distance of 2.1 m to 3 m, they noted.
"Prevention of intraocular injuries is the best treatment, and eye surgeons should be aware of such injuries and the means to prevent them," they said.
The study is published in the July issue of Archives of Ophthalmology.