[Case report of a severe corneoscleral burn caused by the phacoemulsification probe]

We report a case in which a severe corneoscleral burn occurred during the first seconds of a phacoemulsification procedure. The procedure, a superior temporal corneal limbus incision on the right eye, was carried out on a 79-year-old woman presenting a cataract with an average lens density, who had no other risk factors for complications. In spite of a mild nucleus density and routine phacoemulsification equipment (PULSAR - OPTIKON 2000) with resterilizable parts, a severe corneal injury occurred with tissue shrinkage around the surgical wound. It led to an immediate severe astigmatism which only partially decreased in the following 7 months. We discuss the mechanism which may bring about this type of injury and the likely cause in this case. We also describe the primary sign ("lens milk") indicating that the procedure should immediately be stopped, and finally we suggest methods to reduce the incidence of such so-called "phacoburns".