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Editor,—A phacoemulsification (phaco) chopper was accidentally damaged by a phaco handpiece during a phaco cataract surgery. A small fragment was suspected to have dropped into the vitreal cavity. The presence of this tiny intraocular foreign body (IOFB) was missed by the orbital x rays and the computed tomography (CT) scan, but was clearly shown on ultrasound B-scan technique. Pars plana vitrectomy was performed and the foreign body (FB) was found and removed. This case demonstrates the potential hazard caused by the powerful phaco energy as well as the usefulness of the B-scan in detecting small size IOFBs, which may be missed by the standard CT scan.
CASE REPORT
A 72 year old Chinese woman underwent right phaco cataract extraction in December 1996. In the middle of the phaco process, the phaco chopper accidentally came into contact with the tip of the phaco handpiece briefly. No obvious breakage was seen on the chopper and the phaco process was continued. However, when the nucleus removal was completed and the chopper was removed from the eye, it was noted that the chopper had two loose points with two tiny pieces of the instrument easily breaking off from the main body. When these two loose pieces were put back to the breaking points, the instrument appeared to be intact. Missing fragments, however, could not be entirely excluded. A thorough search for any …