Purpose: To present a cluster of cases of corneal edema occurring after pha
coemulsification.
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 a
fter having phacoemulsification.
Results: After 6 months, the edema improved in I patient. Inadvertent intra
ocular use of balanced salt solution (BSS (R)) preserved with benzalkonium
chloride was found to be the cause of this serious complication.
Conclusions: Benzalkonium chloride in concentrations commonly used extraocu
larly is highly toxic to the corneal endothelium. Every possible safeguard
should be taken to prevent inadvertent intraocular use of such preserved so
lutions. (C) 2001 ASCRS and ESCRS.