Sterile Corneal Infiltrates following Cataract Surgery: Case Series
Abstract We report a case series of 26 eyes of 26 patients undergoing planned cataract surgery from December 2021 to March 2022, who were diagnosed as having whitish round infiltrates in the surgical corneal incisions. The infiltrates were detected at the first check after 5–8 days from cataract sur...
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| Veröffentlicht in: | Case Reports in Ophthalmology 2023-09, Vol.14 (1), p.484-490 |
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| creator | Franch, Antonella Bini, Silvia Francescutti, Lorena Birattari, Federica Leon, Pia Bonamartini, Daniele Gambato, Tommaso Altafini, Romeo |
| description | Abstract
We report a case series of 26 eyes of 26 patients undergoing planned cataract surgery from December 2021 to March 2022, who were diagnosed as having whitish round infiltrates in the surgical corneal incisions. The infiltrates were detected at the first check after 5–8 days from cataract surgery and were located either within the main corneal incision and/or in the smaller incisions. Corneal infiltrates (CIs) were single or multiple, without epithelial defects, and painless. All infiltrates were initially treated with full topical antibiotic coverage, in order to control eventual and serious postsurgical infection. However, at daily checks, the clinical course of CIs suggested a sterile etiology. For this reason, steroidal topical treatment was maintained for a long time with slow tapering until complete remission of the CIs. All infiltrates resolved completely in around 30–40 days. The surgical instruments and the sterilization process were scrutinized. A white amorphous material was found mainly on non-disposable anterior chamber cannulas and on irrigation/aspiration tips. Disposable cannulas were adopted, and machinery for cleaning and sterilization procedures were reviewed, with specific reference to water softener renewal. Thanks to these precautions, CIs never occurred again. Finally, our hypothesis was an immune corneal reaction to amorphous deposit on cannula tips. This case series describes a previously unknown complication of cataract surgery and our experience might be useful for other surgeons. |
| doi_str_mv | 10.1159/000533768 |
| format | Article |
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We report a case series of 26 eyes of 26 patients undergoing planned cataract surgery from December 2021 to March 2022, who were diagnosed as having whitish round infiltrates in the surgical corneal incisions. The infiltrates were detected at the first check after 5–8 days from cataract surgery and were located either within the main corneal incision and/or in the smaller incisions. Corneal infiltrates (CIs) were single or multiple, without epithelial defects, and painless. All infiltrates were initially treated with full topical antibiotic coverage, in order to control eventual and serious postsurgical infection. However, at daily checks, the clinical course of CIs suggested a sterile etiology. For this reason, steroidal topical treatment was maintained for a long time with slow tapering until complete remission of the CIs. All infiltrates resolved completely in around 30–40 days. The surgical instruments and the sterilization process were scrutinized. A white amorphous material was found mainly on non-disposable anterior chamber cannulas and on irrigation/aspiration tips. Disposable cannulas were adopted, and machinery for cleaning and sterilization procedures were reviewed, with specific reference to water softener renewal. Thanks to these precautions, CIs never occurred again. Finally, our hypothesis was an immune corneal reaction to amorphous deposit on cannula tips. This case series describes a previously unknown complication of cataract surgery and our experience might be useful for other surgeons.</description><identifier>ISSN: 1663-2699</identifier><identifier>EISSN: 1663-2699</identifier><identifier>DOI: 10.1159/000533768</identifier><identifier>PMID: 37901650</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Antibiotics ; Bromfenac ; Case Report ; Case reports ; Cataract ; cataract surgery ; cataract surgery complication ; Cataracts ; Cornea ; corneal incision ; corneal infiltrates ; Development and progression ; Diagnosis ; Edema ; Etiology ; Eye surgery ; Health aspects ; Hospitals ; Hypotheses ; Medical equipment ; Physiological apparatus ; sterile corneal infiltrate ; Surgeons ; Surgery ; Surgical apparatus & instruments</subject><ispartof>Case Reports in Ophthalmology, 2023-09, Vol.14 (1), p.484-490</ispartof><rights>2023 The Author(s). Published by S. Karger AG, Basel</rights><rights>COPYRIGHT 2023 S. Karger AG</rights><rights>2023 The Author(s). Published by S. Karger AG, Basel. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at: https://uk.sagepub.com/en-gb/eur/reusing-open-access-and-sage-choice-content</rights><rights>2023 The Author(s). Published by S. Karger AG, Basel 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c490t-a80e46682e012021d4a7ec680113422221a847b0052ec4ec849ea486af87ed953</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601887/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601887/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,27635,27924,27925,53791,53793</link.rule.ids></links><search><creatorcontrib>Franch, Antonella</creatorcontrib><creatorcontrib>Bini, Silvia</creatorcontrib><creatorcontrib>Francescutti, Lorena</creatorcontrib><creatorcontrib>Birattari, Federica</creatorcontrib><creatorcontrib>Leon, Pia</creatorcontrib><creatorcontrib>Bonamartini, Daniele</creatorcontrib><creatorcontrib>Gambato, Tommaso</creatorcontrib><creatorcontrib>Altafini, Romeo</creatorcontrib><title>Sterile Corneal Infiltrates following Cataract Surgery: Case Series</title><title>Case Reports in Ophthalmology</title><addtitle>Case Rep Ophthalmol</addtitle><description>Abstract
We report a case series of 26 eyes of 26 patients undergoing planned cataract surgery from December 2021 to March 2022, who were diagnosed as having whitish round infiltrates in the surgical corneal incisions. The infiltrates were detected at the first check after 5–8 days from cataract surgery and were located either within the main corneal incision and/or in the smaller incisions. Corneal infiltrates (CIs) were single or multiple, without epithelial defects, and painless. All infiltrates were initially treated with full topical antibiotic coverage, in order to control eventual and serious postsurgical infection. However, at daily checks, the clinical course of CIs suggested a sterile etiology. For this reason, steroidal topical treatment was maintained for a long time with slow tapering until complete remission of the CIs. All infiltrates resolved completely in around 30–40 days. The surgical instruments and the sterilization process were scrutinized. A white amorphous material was found mainly on non-disposable anterior chamber cannulas and on irrigation/aspiration tips. Disposable cannulas were adopted, and machinery for cleaning and sterilization procedures were reviewed, with specific reference to water softener renewal. Thanks to these precautions, CIs never occurred again. Finally, our hypothesis was an immune corneal reaction to amorphous deposit on cannula tips. This case series describes a previously unknown complication of cataract surgery and our experience might be useful for other surgeons.</description><subject>Antibiotics</subject><subject>Bromfenac</subject><subject>Case Report</subject><subject>Case reports</subject><subject>Cataract</subject><subject>cataract surgery</subject><subject>cataract surgery complication</subject><subject>Cataracts</subject><subject>Cornea</subject><subject>corneal incision</subject><subject>corneal infiltrates</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Edema</subject><subject>Etiology</subject><subject>Eye surgery</subject><subject>Health aspects</subject><subject>Hospitals</subject><subject>Hypotheses</subject><subject>Medical equipment</subject><subject>Physiological apparatus</subject><subject>sterile corneal infiltrate</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical apparatus & instruments</subject><issn>1663-2699</issn><issn>1663-2699</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>M--</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DOA</sourceid><recordid>eNptkU1v1DAQhiMEolXpgTuHSD1x2DL-iO1wQVXEx0qVirRwtib2JHjJxouTLeq_x0uqFZWwD7Zm3nk0M29RvGZwzVhVvwOASgitzLPinCklVlzV9fN__mfF5TRtswxEzQ2rXhZnQtfAVAXnRbOZKYWByiamkXAo12MXhjnhTFPZxWGIv8PYlw3OmNDN5eaQekoP73NkonKTa2l6VbzocJjo8vG9KL5_-vit-bK6vfu8bm5uV07WMK_QAEmlDCdgHDjzEjU5ZYAxIXk-DI3UbR6Hk5PkjKwJpVHYGU2-rsRFsV64PuLW7lPYYXqwEYP9G4ipt5jm4AayLXjk0PpWGy99R-ioFeCPGKfQU2Z9WFj7Q7sj72jMMw9PoE8zY_hh-3hvGShgxuhMuHokpPjrQNNst_GQxrwAy2tQWmVTWFZdL6oec1th7GKmuXw97YKLI-Vtk73RWisuNByHfLsUuBSnKVF36omBPRpuT4Zn7ZtF-xOPrpyUp_TVf9PN3ddFYfe-E38AMHKv-g</recordid><startdate>20230926</startdate><enddate>20230926</enddate><creator>Franch, Antonella</creator><creator>Bini, Silvia</creator><creator>Francescutti, Lorena</creator><creator>Birattari, Federica</creator><creator>Leon, Pia</creator><creator>Bonamartini, Daniele</creator><creator>Gambato, Tommaso</creator><creator>Altafini, Romeo</creator><general>S. 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We report a case series of 26 eyes of 26 patients undergoing planned cataract surgery from December 2021 to March 2022, who were diagnosed as having whitish round infiltrates in the surgical corneal incisions. The infiltrates were detected at the first check after 5–8 days from cataract surgery and were located either within the main corneal incision and/or in the smaller incisions. Corneal infiltrates (CIs) were single or multiple, without epithelial defects, and painless. All infiltrates were initially treated with full topical antibiotic coverage, in order to control eventual and serious postsurgical infection. However, at daily checks, the clinical course of CIs suggested a sterile etiology. For this reason, steroidal topical treatment was maintained for a long time with slow tapering until complete remission of the CIs. All infiltrates resolved completely in around 30–40 days. The surgical instruments and the sterilization process were scrutinized. A white amorphous material was found mainly on non-disposable anterior chamber cannulas and on irrigation/aspiration tips. Disposable cannulas were adopted, and machinery for cleaning and sterilization procedures were reviewed, with specific reference to water softener renewal. Thanks to these precautions, CIs never occurred again. Finally, our hypothesis was an immune corneal reaction to amorphous deposit on cannula tips. This case series describes a previously unknown complication of cataract surgery and our experience might be useful for other surgeons.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>37901650</pmid><doi>10.1159/000533768</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Antibiotics Bromfenac Case Report Case reports Cataract cataract surgery cataract surgery complication Cataracts Cornea corneal incision corneal infiltrates Development and progression Diagnosis Edema Etiology Eye surgery Health aspects Hospitals Hypotheses Medical equipment Physiological apparatus sterile corneal infiltrate Surgeons Surgery Surgical apparatus & instruments |
| title | Sterile Corneal Infiltrates following Cataract Surgery: Case Series |
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