Burn during a routine pterygium excision operation

PURPOSE. To report a patient who sustained a spark fire burn during a routine pterygium operation. METHODS. A 40-year-old woman was referred for pterygium excision in her left eye. During the operation a low temperature cautery caused a spark fire that resulted in left eye corneal burn, upper and lower eyelid burns, and melting of eyelashes and eyebrows bilaterally. RESULTS. Topical antibiotics and vitamin C followed by topical corticosteroids were given. After 1 week the corneal epithelium healed but a paracentral corneal opacity developed. Two months later on last follow-up visit, a mild diffuse corneal opacity was still seen. The combination of three elements found in most routine (ophthalmologic) surgical fields-an enriched oxygen environment with the high temperature transmitted by the electrocautery in the vicinity of hair-might explain the event. CONCLUSIONS. Surgeons should try to separate these three elements or eliminate any of them, in order to minimize or prevent such events.