Intraocular ophthalmic ointment following anterior segment surgery

Abstract

A 79-year-old man had uneventful phacoemulsification at an outside facility. During the postoperative period, his vision worsened secondary to chronic cystoid macular edema (CME). The patient was referred to the Veteran Affairs Boston Healthcare System for review 2 years and 4 months after the initial cataract procedure. The CME was confirmed, and a large pearly white globule that moved with changes in head position was noted. Surgical removal was performed, and nuclear magnetic resonance spectroscopy identified the unknown substance as petroleum jelly. The patient was treated with topical ketorolac tromethamine and prednisolone acetate with subsequent resolution of inflammation and CME, resulting in a corrected distance visual acuity of 20/25. The visual acuity was maintained 5 years after surgery. This case highlights the importance of ensuring the integrity of clear corneal incisions and suggests that use of topical ointment at the conclusion of a clear corneal case should be avoided.