Abstract
Purpose: To present a cluster of cases of corneal edema occurring after phacoemulsification. Setting: Regional hospital in rural Australia. Methods: This retrospective case series comprised 12 patients from a single surgical list comprising 19 cases who developed persistent corneal edema after having phacoemulsification. Results: After 6 months, the edema improved in 1 patient. Inadvertent intraocular use of balanced salt solution (BSS®) preserved with benzalkonium chloride was found to be the cause of this serious complication. Conclusions: Benzalkonium chloride in concentrations commonly used extraocularly is highly toxic to the corneal endothelium. Every possible safeguard should be taken to prevent inadvertent intraocular use of such preserved solutions.
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