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Photo quiz: Corneal edema after uneventful cataract surgery
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This patient had uneventful cataract surgery 2 weeks earlier and presents with 20/25 vision with some peripheral corneal edema and persistent cell and flare (Fig. 1). Does everything look good to you and are you ready to schedule surgery for his other eye?
Fig. 1. This patient has 20/25 vision but some inferior corneal edema after cataract surgery 2 weeks earlier.
Since the corneal edema is focal, inferior in this case, is there a reason why this would be present 2 weeks after an uncomplicated cataract surgery? Upon closer inspection with adjustment of the lighting, we can see that there is a large nuclear cataract piece wedged in the inferior angle (Fig. 2). This is causing inflammation as well as focal corneal endothelial damage and edema.
Fig. 2. There is a retained nuclear cataract piece wedged in the inferior angle of the eye.
At this point the patient was brought back to the operating room to evacuate the fragment. In order to prevent this fragment from getting lost behind the iris, preoperative miotic drops were instilled and then viscoelastic was used to trap the nuclear piece before putting the phaco probe into the eye.
The patient had a quick recovery and went on to have an uneventful cataract surgery in the other eye.