Eyelash Impalement of Iris After Uncomplicated Cataract Surgery

TL;DR

A patient developed an intraocular eyelash after cataract surgery, which was later removed without complications.

Contribution

This is the first documented case of an intraocular eyelash embedded in the iris after cataract surgery.

Findings

An intraocular eyelash was found embedded in the iris one week after cataract surgery.

The patient's vision improved to 20/20 after the foreign body was removed.

No signs of endophthalmitis or significant inflammation were observed post-removal.

Abstract

This report highlights the first known report of an intraocular eyelash embedded in the inferior midperipheral iris following a routine cataract surgery. A 74-year-old female presented 5 months postoperatively from a full-thickness macular hole repair with a 3+ nuclear sclerotic cataract. She underwent an uneventful left eye cataract extraction with insertion of posterior chamber intraocular lens (PCIOL). Review of surgical video revealed well-draped eyelashes and no introduction of an eyelash into the anterior chamber at any point during surgery. The first postoperative visit was notable for no foreign bodies and centered PCIOL. Then, 1 week postoperatively, the anterior segment examination revealed a linear foreign body embedded in the inferior midperipheral iris, without corneal endothelium touch. The foreign body was removed in the operating room and revealed to be an eyelash by pathology. The patient's visual acuity during her first two postoperative visits was 20/30 and improved to 20/20 with refraction at her 1-month postoperative visit. There was minimal postoperative inflammation and no evidence of endophthalmitis. To prevent introduction of an intraocular eyelash associated with cataract surgery, appropriate measures intraoperatively and postoperatively should be taken, including meticulous draping of the eyelashes and lids, diligent corneal wound hydration, and clear patient education.

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