A Non-expected and Extreme Complication of Phacoemulsification: Scleral Wall Rupture

Abstract

Rupture of the scleral wall during intraocular surgeries is extremely rare even in patients with a history of trauma, underlying ocular or systemic autoimmune disease. In this report, we describe a single case of a partial scleral wall rupture during phacoemulsification. We aim to discuss this extreme complication and to highlight the importance of a trauma history before phacoemulsification. An 84-year-old patient was hospitalized with the plan of phacoemulsification surgery. During phacoemulsification, conjunctival chemosis appeared all around the limbus and subconjunctival hemorrhage at nasal side. After conjunctival dissection, partial scleral rupture was detected. Iris-choroid were expelled from the wound. Phacoemulsification was immediately stopped and wound was closed primarily. There were no signs or symptoms of prior inflammation, and rheumatologic workup was negative. Nevertheless, the patient had an old ocular blunt trauma history. During the examination of a patient with a trauma history, scleral wall structure should not be overlooked. Weakness in scleral wall could lead to detrimental complications during intraocular surgeries.