title: Acute intraoperative rock-hard eye syndrome and its management.
abstract: OBJECTIVE
  To evaluate the use of pars plana needle aspiration of retrolenticular fluid in the immediate management of an acute intraoperative rock-hard eye syndrome (AIRES).
  
  
  METHODS
  Private practice, Sydney, Australia.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Data over an 18-month period were collected to evaluate efficacy, complications, and visual outcomes in patients who had pars plana needle aspiration for management of AIRES, which is an acute intraoperative shallowing of the anterior chamber and a marked increase in intraocular pressure (IOP) during phacoemulsification cataract surgery but without evidence of a choroidal hemorrhage. Preoperative and postoperative (1 day, 1 week, and 1 month) data were evaluated. Resolution of AIRES and postoperative posterior segment status, IOP, and corrected distance visual acuity (CDVA) were the main outcome measures.
  
  
  RESULTS
  Acute intraoperative rock-hard eye syndrome occurred in 6 (1.45%) of 413 surgeries. All 6 patients were women with a mean age of 81 years. Four patients had dense nuclear cataracts. In each case, the anterior chamber depth and IOP normalized immediately after pars plana needle aspiration and the procedure concluded uneventfully. Mild vitreous hemorrhage was observed in 1 patient postoperatively. At 1 month, the IOP was normal in 5 of 6 cases, while the CDVA was 20/12 in 5 of 6 cases.
  
  
  CONCLUSIONS
  Although the etiology of AIRES is iatrogenic, immediate resolution was achieved uneventfully with pars plana needle aspiration, which appears to be a safe management technique with satisfactory outcomes.
authors.affiliation: From the Department of Ophthalmology (Lau, Lim, Chen, Ruan, Agar, Francis), Prince of Wales Hospital, the University of New South Wales (Lim, Chen, Ruan, Agar, Francis), and the Ophthalmic Surgery Centre (Lau, Montfort, Sim, Lim, Agar, Francis), Sydney, New South Wales, Australia.
authors.forename: Oliver C F
authors.initials: OC
authors.lastname: Lau
authors.affiliation: From the Department of Ophthalmology (Lau, Lim, Chen, Ruan, Agar, Francis), Prince of Wales Hospital, the University of New South Wales (Lim, Chen, Ruan, Agar, Francis), and the Ophthalmic Surgery Centre (Lau, Montfort, Sim, Lim, Agar, Francis), Sydney, New South Wales, Australia.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Montfort
authors.affiliation: From the Department of Ophthalmology (Lau, Lim, Chen, Ruan, Agar, Francis), Prince of Wales Hospital, the University of New South Wales (Lim, Chen, Ruan, Agar, Francis), and the Ophthalmic Surgery Centre (Lau, Montfort, Sim, Lim, Agar, Francis), Sydney, New South Wales, Australia.
authors.forename: Benjamin W C
authors.initials: BW
authors.lastname: Sim
authors.affiliation: From the Department of Ophthalmology (Lau, Lim, Chen, Ruan, Agar, Francis), Prince of Wales Hospital, the University of New South Wales (Lim, Chen, Ruan, Agar, Francis), and the Ophthalmic Surgery Centre (Lau, Montfort, Sim, Lim, Agar, Francis), Sydney, New South Wales, Australia.
authors.forename: Chris H L
authors.initials: CH
authors.lastname: Lim
authors.affiliation: From the Department of Ophthalmology (Lau, Lim, Chen, Ruan, Agar, Francis), Prince of Wales Hospital, the University of New South Wales (Lim, Chen, Ruan, Agar, Francis), and the Ophthalmic Surgery Centre (Lau, Montfort, Sim, Lim, Agar, Francis), Sydney, New South Wales, Australia.
authors.forename: Tony S C
authors.initials: TS
authors.lastname: Chen
authors.affiliation: From the Department of Ophthalmology (Lau, Lim, Chen, Ruan, Agar, Francis), Prince of Wales Hospital, the University of New South Wales (Lim, Chen, Ruan, Agar, Francis), and the Ophthalmic Surgery Centre (Lau, Montfort, Sim, Lim, Agar, Francis), Sydney, New South Wales, Australia.
authors.forename: Claire W
authors.initials: CW
authors.lastname: Ruan
authors.affiliation: From the Department of Ophthalmology (Lau, Lim, Chen, Ruan, Agar, Francis), Prince of Wales Hospital, the University of New South Wales (Lim, Chen, Ruan, Agar, Francis), and the Ophthalmic Surgery Centre (Lau, Montfort, Sim, Lim, Agar, Francis), Sydney, New South Wales, Australia.
authors.forename: Ashish
authors.initials: A
authors.lastname: Agar
authors.affiliation: From the Department of Ophthalmology (Lau, Lim, Chen, Ruan, Agar, Francis), Prince of Wales Hospital, the University of New South Wales (Lim, Chen, Ruan, Agar, Francis), and the Ophthalmic Surgery Centre (Lau, Montfort, Sim, Lim, Agar, Francis), Sydney, New South Wales, Australia. Electronic address: iancfrancis@gmail.com.
authors.forename: Ian C
authors.initials: IC
authors.lastname: Francis
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000473:pathology; D004322:Drainage / Q000379:methods*; D005128:Eye Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D009798:Ocular Hypertension / Q000175:diagnosis / Q000601:surgery; D018918:Phacoemulsification; D012189:Retrospective Studies; D013577:Syndrome; D014792:Visual Acuity / Q000502:physiology