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JAMA Ophthalmology Clinical Challenge
February 11, 2021

Nonclearing Corneal Edema After Phacoemulsification and Intraocular Lens Implantation

Author Affiliations
  • 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
JAMA Ophthalmol. 2021;139(4):480-481. doi:10.1001/jamaophthalmol.2020.4660

An 82-year-old man with an ocular history significant for bilateral nuclear sclerotic cataracts presented to the Cornea Service at Bascom Palmer Eye Institute, Miami, Florida, with a history of blurred vision in the right eye after phacoemulsification cataract extraction 8 weeks earlier. Current ophthalmic medications included topical prednisolone acetate, 1%, in the right eye 6 times per day. The patient reported no improvement with the treatment. On examination, his best-corrected visual acuity was 20/80 OD and 20/20 OS. Pupils were reactive without relative afferent pupillary defect, and intraocular pressures were 18 mm Hg in the right eye and 11 mm Hg in the left eye. A slitlamp biomicroscopic examination of the right eye revealed grade 2 to 3 diffuse central corneal edema and folds (Figure 1). The anterior chamber was deep and the posterior chamber intraocular lens was in good position within the capsular bag. Although the view to the posterior pole of the right eye was hazy owing to corneal edema, dilated fundus examination findings were unremarkable. Examination of the left eye revealed a few guttate. The central corneal thickness by ultrasound pachymetry was 957 μm in the right eye and 547 μm in the left eye.

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