WAILEA, Hawaii — A surgeon shared the valuable lessons she learned during a nightmare case of phacoemulsification in which the chopper she was using broke after coming into contact with the phaco needle.
| || |
During the cataract surgery complications session here at Hawaiian Eye 2009, Rosa Braga-Mele, MD, shared a video of a case in which this happened to her, what went wrong, how she corrected the situation and what she learned from it.
First, Dr. Braga-Mele said, the surgeon should not panic and withdraw his or her hands. Instead, the surgeon should remain calm, assess the situation and use a dispersive viscoelastic to stabilize the anterior chamber.
"What I should have done was put in viscoelastic under that piece while my phaco stayed in," she said.
She also said it was important after removing the metal pieces to check the integrity of the capsule before continuing to avoid a dropped nucleus.
"What I could have done was put in dispersive viscoelastic, put in a sheets glide, popped everything up, phacoemulsified over the sheets glide and had a more controlled case," she said.
Dr. Braga-Mele said she has published studies in the Canadian Journal of Ophthalmology showing that this complication occurs more regularly than surgeons realize. She has used her case to teach others of how to be prepared to deal with the situation.
"This can happen to anybody. This can happen to you," she said.