Intraocular foreign body during cataract surgery

Introduction: A large foreign body entered the anterior chamber through the infusion tubing during phacoemulsification. Patient and Clinical Findings: A 70-year-old woman presented for routine cataract extraction with implantation of a posterior chamber intraocular lens. During the phacoemulsification, a white fleck was captured on video entering the eye through the infusion tubing. Diagnosis, Intervention, and Outcomes: The fleck was removed immediately with a forceps through the main incision, and the surgery was completed. The fragment was preserved and sent for analysis. Scanning electron microscopy and energy-dispersive x-ray spectroscopy were used to determine its composition. Conclusions: The origin of the fragment was consistent with the spike used to pierce the bag containing the balanced salt solution.