Retinal phototrauma during intra-ocular lens-implantation

The use of the operating microscope has become almost a necessity in the surgery of the anterior segment of the eye. However the coaxial light of the operating microscope is potentially hazardous for the retina, especially during intra-ocular lens implantation. The risk of producing a photic retinopathy increases if the duration of the surgical procedure is prolonged once the pseudophakos is in the eye and if high levels of illumination are used. We encountered our first case in a patient, whose intervention was filmed and where thus an increased illumination was needed. This complication is however also found in cases where no extra illumination was needed. As the clinical signs are usually very mild, the retinal lesions related to over-exposure to light are easily overlooked.