Accidental Entry of Ointment in Anterior Chamber Postcataract Surgery: A Clinical Conundrum

Postoperative complications of cataract surgery are uncommon, and accidental entry of topical ointment into the anterior chamber is a particularly rare event. We report the case of a 67-year-old male with bilateral cataracts and old macular scar in the right eye asteroid hyalosis in the left eye, who developed intraocular migration of 6% sodium chloride ointment following uncomplicated small-incision cataract surgery. On postoperative day 1, a whitish, semi-solid, free-floating material was observed in the anterior chamber, accompanied by mild corneal edema and 1+ anterior chamber cells (SUN classification), initially raising suspicion of early toxic anterior segment syndrome. Due to diagnostic uncertainty, anterior chamber irrigation was performed, during which the material's consistency confirmed the diagnosis of intraocular ointment entry. This case highlights a rare but important postoperative complication and underscores the need to recognise potential routes of ointment migration, including subtle wound gaping or side-port entry, particularly in patients who may squeeze the eye postoperatively.