Thermal Burns Caused by Ophthalmic Viscosurgical Device Occlusion in Torsional Phacoemulsification.

Abstract: Heat is a byproduct of phacoemulsification, which can lead to phacoburns. Torsional phacoemulsification has been reported to generate less heat and hence fewer phacoburns. We describe three cases of phacoburns during torsional phacoemulsification, which were caused by ophthalmic viscosurgical device (OVD) occlusion. Prominent phacoburns occurred at the beginning of sculpting using torsional phacoemulsification. The tips and tubing were patent on examination. Occlusion sounds disappeared after aspiration of OVD. The corneal wounds were closed with sutures, leaving the adhesion of the iris to the corneal wounds. Separation of the iris from the cornea was done later, and a central round pupil was achieved in Cases 2 and 3. Astigmatism improved with time in all three patients. OVD still needs to be cleared around the tip before torsional phacoemulsification is activated. Once a thermal burn has occurred, sutures with acceptable adhesion of the iris to the wound and delayed separation may be considered. [ABSTRACT FROM AUTHOR]