THROWING UP HALFWAY THROUGH PHACOEMULSIFICATION: HOW TO PREVENT POTENTIAL SUPRACHOROIDAL HAEMORRHAGE.

During routine cataract surgery in a 72-year-old female patient, I was performing phacoemulsification to remove divided lens and there was a sudden and dramatic head movement from her, who was experiencing a panic attack and said ‘I want to throw up’. I urgently replied ‘hold on for 10 seconds’. Promptly, I safely removed the instruments and filled the eye with cohesive viscoelastic before she sat up and vomited with the drape and speculum still attached to the eye.

This was an unfinished case and unsecured wound. Almost 20 minutes later, she recovered and wanted to proceed again. This video demonstrated clear cornea, no posterior capsule rupture and no occurrence of suprachoroidal haemorrhage after the episode of vomiting and intense Valsalva maneuver.

Clear communication and quick injection of viscoelastic to stabilise anterior chamber prevented potentially devastating complications. The rest of surgery was carried out uneventfully with an excellent post-operative outcome.