Ophthalmology expert witness advises on cataract surgery that resulted in vision loss from corneal burn

There are some inconsistencies with the reported events and the outcome of severe corneal burn. If the phacoemulsification power was changed to infusion, as reported by the defendant, only after the phacoemulsification machine began to chime, there would be little time for a corneal burn of this severity to occur. Although there are many reasons why a corneal burn can occur, including an empty infusion bottle, infusion bottle height too low, irrigation tubing crimped, occlusion/clogged phacoemulsification tip, too tight of an incision or even improper tuning of the phacoemulsification machine, most of these situations should be recognized, identified, and rectified in a timely fashion to prevent severe corneal burns.

In the operative report, the statement that after the cornea was noted to turn white at the incision site, the “phacoemulsification was re-tuned and then the phacoemulsification probe was reinserted” leads to speculation that perhaps the machine was improperly tuned at the beginning of the case. There have been documented cases of corneal burns as a result of improper tuning of the phacoemulsification machine. Regardless of the actual cause, the complication of a severe corneal burn, causing scarring and high astigmatism, deviates from what would be considered standard of care for phacoemulsification surgery.