title: Cataract surgery in a case of carotid cavernous fistula.
abstract: A carotid-cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system. The ocular manifestations include conjunctival chemosis, proptosis, globe displacement, raised intraocular pressure and optic neuropathy. Although management of CCF in these patients is necessary, the ophthalmologist may also have to treat other ocular morbidities such as cataract. Cataract surgery in patients with CCF may be associated with many possible complications, including suprachoroidal hemorrhage. We describe cataract extraction surgery in 60-year-old female with bilateral spontaneous low-flow CCF. She underwent phacoemulsification via a clear corneal route under topical anesthesia and had an uneventful postoperative phase and recovered successfully. Given the various possible ocular changes in CCF, one must proceed with an intraocular surgery with caution. In this communication, we wish to describe the surgical precautions and the possible pitfalls in cataract surgery in patients with CCF.
authors.forename: Akshay Gopinathan
authors.initials: AG
authors.lastname: Nair
authors.affiliation: Department of Neuro-Ophthalmology; Jaslok Community Ophthalmic Centre, Sankara Nethralaya, Chennai, India.
authors.forename: Smita Vittal
authors.initials: SV
authors.lastname: Praveen
authors.forename: Veena Olma
authors.initials: VO
authors.lastname: Noronha
mesh_terms: D020216:Carotid-Cavernous Sinus Fistula / Q000150:complications* / Q000175:diagnosis; D002386:Cataract / Q000150:complications*; D002387:Cataract Extraction / Q000379:methods*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged