To report a case of severe corneal burn during phacoemulsification that was successfully managed with a second operation and medical treatment.

An 89-year-old female had phacoemulsification of a mature cataract in her right eye, and was transferred to our outpatient clinic after development of a thermal burn at the corneal incision site. On initial examination, visual acuity was light perception and slit-lamp examination revealed diffuse, severe corneal edema, and a 3.0 × 3.0 mm-sized epithelial defect with severe stromal opacity around the incision site. Extracapsular cataract extraction through superior scleral incision was performed with posterior chamber implantation of a 3-piece hydrophobic acrylic intraocular lens (IOL). Topical steroids as well as hypertonic saline were used to manage corneal edema postoperatively. One month postoperatively, her best corrected visual acuity was 0.06 and slit-lamp examination showed markedly decreased corneal edema and epithelial defect. Three months postoperatively, her best corrected visual acuity was 0.2, the IOL was centered in the capsular bag, and corneal edema nearly disappeared with remnant moderate corneal opacities.

We report successful treatment of severe corneal burn during phacoemulsification managed with extracapsular cataract extraction through scleral incision and medical treatment.