1253: preventing a phaco wound burn

An anonymous resident emailed me with a thank you because a pearl that was learned here on CataractCoach prevented a phaco wound burn in his patient. Here is the email:

Near miss: how Cataract Coach saved me from a phaco wound burn

Hi Dr. Devgan, I hope this message reaches you well. Attached is my surgical video (Case #53 for me), which is a CEIOL (toric) with iStent inject. I’m a big fan and really appreciate all of your videos. This is an example of where there was blockage of flow while performing phaco. On initial sculpting, I heard the dinging sound from phaco and noticed an abnormal white cloud over lens. Then, I immediately recalled the phaco wound burn video on your website and stopped. It was tempting to continue sculpting thinking that it was just cortex but I was glad to watch the video on your website a couple of weeks prior to this case. I then instructed the tech to check the phaco tip and found that it was not tested appropriately. A new sleeve was brought, phaco tip flushed and tightened again, then proceeded safely with remainder of the case.

click to learn this important lesson of preventing a phaco wound burn:

link here


  1. phaco. wound burn:
    Dear Prof:Devgan
    I enjoy watching your videoes and I have learnt a lot from you.
    I have started my phaco. training in as senior house officer in ophthalmology and now I am a consultant ophthalmologist
    With the Covid problem many theatre sessions were cancelled and in the last year I did about 20 cataract cases:last week I did two cases after 3 months break.
    I got a bit stressed and a bit shaky when i return to phaco surgery after a long break.:Any tips on how to overcome stress caused by cataract surgery?
    In my first cataract list as a substantive consultant ophthalmologist ,the phaco tip got blocked and I could notice the corneal wound becoming hazy and white and the cataract material was fried like a white thread in AC:the sane when we boil the egg white :this happened very quickly in few seconds/I had to stop and check the phaco. hand piece:this was my first phaco. wound burn since many years in a patient
    I had to put 5 sutures in 2.2 MM wound to seal it.
    The rest of surgery went well /after 3 months I removed the sutures:still vision is not good as the patient has significant astigmatism :more than 6 diopters of cylinder:will this get better with time?

    I think that you are doing a great job /keep the good work.

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