Metallic fragment deposits during phacoemulsification

Abstract

Purpose: To describe the nature and origin of foreign metallic intraocular bodies appearing after phacoemulsification.

Setting: Department of Ophthalmology, University Hospital of San Juan, Alicante, Spain.

Methods: Two metallic particles, 1 extracted during surgery and the other from a patient in whom surgery had been performed, were studied by scanning electronic microscopy and X-ray dispersive energy spectroscopy. Also evaluated were all metallic elements used in phacoemulsification including phaco tips, Sinskey hooks, and handpieces. A morphologic analysis at various magnifications was performed and the composition of the elements studied.

Results: Scanning electronic microscopy showed irregularities of the phaco tip and Sinskey hook after their use. Spectrographic analysis found that the phaco tip was mainly aluminum and titanium; the Sinskey hook, iron, chromium, cobalt, and nickel; the handpiece, iron, chromium, and nickel; and the 2 metallic particles, iron, chromium, and nickel, the same as the handpiece.

Conclusion: The metallic particles extracted corresponded to those of the phaco handpiece. Vibration during prolonged use of the phacoemulsifier probably caused these particles to chip off the handpiece.