J-Cannula Became Loose and Ejected

During this routine phaco, J-Cannula Became Loose and Ejected into the eye at a very high pressure. This happened as the nurse, which is one of my best nurses, did not tighten the J-cannula to the syringe. This resulted in PC tear, retinal/chorioidal trauma with vitreous hge. This was managed by immediately injecting Vitrax into the vitreous cavity, 2 vials were needed. Anterior vitrectomy was done and the IOL AR40e was implanted into the sulcus with rhexis capture, where you push the optic behind the CCC. First PO day vision was 20/40. On the last visit, UCVA was 20/25+1, not bad. I did 2 retina lasers around the area where the cannula hit the retina. Thank God, this nice patient is doing fine.

Category:

People & Blogs

Tags:

• J-Cannula
• Loose
• Ejected
• PC
• tear
• retinal/chorioidal
• trauma
• vitreous
• hge
• Vitrax
• Anterior
• vitrectomy
• IOL
• AR40e
• sulcus
• rhex

[taay007]

Great advice. That is what I do now to stabilized and secure the cannulas, all of them, esp the J-cannula, as I use a lot of pressure.

[robkaufer]

Great case and very educational. I have been taught to ALWAYS keep my left hand securing the cannula and I´ve prevented many situations like this. Not only with BSS but also with viscoelastic. Thanks!

[potech]

It is a great video.

I had a same situation during hydropolishing the posterior capsule.

[potech]

It is a great video.

I had a same situation during hydropolishing the posterior capsule.

[tubeshunts]

There is a similar incident reported by Steven Suh, MD at phacopearls com in the incision section ("A CASE OF A FLYING CANNULA") where the hydration cannula shoots half across the cornea but stays in the stroma.