Cataract Quiz: What is this white plume?

The phaco probe is placed in the eye at the beginning of the cataract surgery and when ultrasonic energy was applied, a white plume of material appeared at the tip. What is this material? Is there a danger here? Will it cause an infection or inflammation? What is your next step?

Click below to learn from this cataract quiz about this white plume:


  1. It looks like the phaco tip was completely clogged, or the aspiration tube was folded, or the aspiration malfunctioned. When there’s no aspiration the emusified lenticular matter comes in the anterior chamber, mostly in very hard nuclei. Normally it disperses, but in this eye the white cloud did not because the anterior chamber was filled with OVD. Maybe even both the aspiration and the irrigation were blocked, as there is no egress of BSS visible neither through the main port nor via the side port when the phaco is activated the first time. So the white material did not come out of the phaco tip but arose in front of it.

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