Cannula-associated Ocular Injuries during Cataract Surgery: A Preventable Intraoperative Complication?

Although rare, inadvertently dislodged cannula can occur during cataract surgery. We report two cases of cannula-associated ocular injury during stromal hydration of the main corneal incision despite the use of Luer-lock syringes. Case 1 suffered from an initially occult intraocular injury which led to a delayed presentation of vitreous prolapsing into the anterior chamber, presumed posterior capsular rupture, vitreous hemorrhage, and multiple retinal tears, which required a three-port pars plana vitrectomy and cryotherapy. Case 2 sustained an iris laceration, anterior capsular tear, and postoperative raised intraocular pressure with no late sequelae. The former case highlights the need for close monitoring postoperatively despite the absence of initial apparent evidence of intraocular injury. Herein, we propose a systematic approach in reducing the risk of inadvertent cannula-associated ocular injury.