Abandoned To Accomplished: Aborted Phacoemulsification Completed After A Two-Month Interval

To describe the clinical course and outcome in a case of successful phacoemulsification and intraocular lens placement in a patient with previously aborted cataract surgery 2 months prior.

The Eye Foundation, Coimbatore, a tertiary Eye Care Centre in Southern India

A 56-year-old woman presented with diminished vision in the right eye (OD) after cataract surgery was abandoned mid-phacoemulsification at another facility 2 months prior due to cardiac instability. Slit lamp examination revealed a fibrosed rim of a continuous curvilinear capsulorrhexis, and a partially trenched nucleus in OD. She underwent successful phacoemulsification and in-the-bag IOL implantation. Postoperatively, OD was noted to have advanced glaucomatous optic disc cupping and superior macular branch vein occlusion with cystoid macular edema(CME). While intraocular pressure remained normal throughout the postoperative period, topical dorzolamide 2% was commenced. Intravitreal ranibizumab injection was administered for CME, which ultimately resolved. The best-corrected vision in OD improved to 20/25 at the last visit, 5 months after the surgery.

Although infrequent, abandoned cataract surgeries can be successfully managed after addressing the ocular or systemic comorbidities that necessitated the abortion of the primary surgery. However, a prolonged interval can lead to suboptimal outcomes due to vision-threatening complications such as glaucoma and CME, which may be precipitated by intraocular inflammation in the interim period.