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Recent advances in the technique of phacoemulsification have led to an increase in the number of cataract surgeries performed worldwide, consequently leading to a higher incidence of surgery-related complications than seen previously. We present a case of post-phacoemulsification corneal oedema that was referred to us for corneal transplantation. The clinical features, investigations and management protocol used in this case are described.
A patient was referred to our clinic for endothelial keratoplasty. He underwent phacoemulsification with intraocular lens implantation in his right eye 7 weeks before presentation. Notes on the referral letter mentioned an uneventful operation with persistent corneal oedema beginning from the first postoperative day. At the time of presentation, the best-corrected distance visual acuity (BDVA) was 0.1 OD and 0.8 OS. Slit lamp examination showed dense corneal oedema which was sharply demarcated from an area of relatively clear cornea on the temporal side (figure 1A, black arrows). However, the area of corneal oedema extended up to the limbus from 1 to 6 o’ clock (figure 1A, white arrows). Corneal wounds were intact and the anterior chamber was deep. Details of the anterior chamber inflammation could not be seen owing to significant corneal oedema. Left eye examination showed mild nuclear sclerosis. Intraocular pressure with non-contact tonometry was 10 mm Hg OD and 12 mm Hg OS. Pupillary reactions were normal.