We must examine our instruments before using them to ensure that they are intact and in normal, working condition. In rare cases, we can be handed an instrument which is broken and thus will not function as well. In a prior case, we showed that the inability to chop a cataract was due to having a broken chopper tip.
The chance of being given a broken instrument is low, likely less than one percent. But it does happen and for high-volume cataract surgeons, 1% means that It can happen many times per year. In this case, I was handed a broken chopper so I asked for a replacement. And then it turns out that the replacement chopper was also broken. Finally, the third chopper was in good order and the case went beautifully. Never blame the scrub technician for handing you an instrument with a broken tip because, without a microscope, these tips are very difficult to see. You, the surgeon, have the benefit of examining the instrument tip with the magnification from the microscope.
If you have a situation where you notice a broken tip after the instrument has already been used in the eye, you must make certain that a piece of the broken tip is not inside the eye. It helps if you video record all of your surgeries (even if you erase or record over the files later) so that you can stop, rewind the video and see if the instrument tip was broken before it was even used in the eye.
Click below to learn the lesson about examining your instruments prior to using them:
