Sir,
Saha and Price report a case of severe intraocular damage due to a Rycroft cannula flying loose during cataract surgery,1 and suggest that the routine use of luer-lock syringes will reduce the risk of this. Similar adverse events have been reported previously.2 The most important measure that can preclude such unfortunate occurrences is to handle all syringes bimanually while undertaking any intraocular manoeuvres. One hand controls the barrel and the plunger, and the other hand firmly grasps the hub of the cannula or needle at its attachment to the syringe. The second hand can thus feel a cannula giving way, if this were to occur, and prevent it flying loose into the eye. I have also found that the bimanual grasp improves the control and manipulation of the tip.
References
Saha N, Price NC . Lagrogenic retinal tear and vitreous haemorrhage with Rycroft cannula during phacoemulsification cataract surgery. Eye 2003; 17(2): 260–261.
Dinkaran S, Kayarkar VV . Intraoperative ocular damage caused by a cannula. J Cataract Refract Surg 1999; 25(5): 720–721.
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Prasad, S. Minimising the risk of iatrogenic intraocular damage. Eye 19, 484 (2005). https://doi.org/10.1038/sj.eye.6701485
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DOI: https://doi.org/10.1038/sj.eye.6701485