Metallic fragment deposits during phacoemulsification

To describe the nature and origin of foreign metallic intraocular bodies appearing after phacoemulsification.

Department of Ophthalmology, University Hospital of San Juan, Alicante, Spain.

Two metallic particles, 1 extracted during surgery and the other from a patient in whom surgery had been performed, were studied by scanning electronic microscopy and X-ray dispersive energy spectroscopy. Also evaluated were all metallic elements used in phacoemulsification including phaco tips, Sinskey hooks, and handpieces. A morphologic analysis at various magnifications was performed and the composition of the elements studied.

Scanning electronic microscopy showed irregularities of the phaco tip and Sinskey hook after their use. Spectrographic analysis found that the phaco tip was mainly aluminum and titanium; the Sinskey hook, iron, chromium, cobalt, and nickel; the handpiece, iron, chromium, and nickel; and the 2 metallic particles, iron, chromium, and nickel, the same as the handpiece.

The metallic particles extracted corresponded to those of the phaco handpiece. Vibration during prolonged use of the phacoemulsifier probably caused these particles to chip off the handpiece.