Fibres Found in the Eye During and After Phacoemulsification Cataract Surgery

Abstract

Background:
Phacoemulsification is the most common technique for cataract extraction worldwide. Although generally safe, intraocular contamination with foreign materials such as fibres may occur during or after surgery, potentially leading to inflammation, visual disturbances, or postoperative complications.
Objective:
To identify and characterize the occurrence, type, and clinical relevance of fibres found in the anterior chamber during and after phacoemulsification cataract surgery.
Methods:
A prospective observational study was conducted on 150 patients undergoing uneventful phacoemulsification over a 6-month period. Intraoperative and postoperative slit-lamp examinations were performed to detect fibres in the anterior chamber. The source and type of fibres were evaluated microscopically, and their clinical impact was monitored during follow- up.

Results:
Fibres were detected in 18 eyes (12%) during or within 1 week post-surgery. The most common sources included cotton surgical swabs, lint from surgical gowns or drapes, and residual cellulose from IOL packaging. Most fibres were inert and did not provoke significant inflammation. In 3 cases (2%), mild anterior chamber reaction was noted, resolving with topical steroids. No cases of endophthalmitis or persistent uveitis were observed. Fibre presence did not affect final visual acuity in any patient.
Conclusion:
Foreign fibres may be inadvertently introduced into the anterior chamber during phacoemulsification, primarily from surgical materials. Although largely benign, their presence warrants careful surgical technique and postoperative monitoring to prevent inflammatory sequelae.