Royal College of Ophthalmologists issues safety alert over cannula detachments

Posted: 24/04/2018

The Royal College of Ophthalmologists has issued a safety alert to its members over the use of cannulas during ophthalmic surgery. This follows a report from NHS Improvement’s national patient safety team. That study highlights a continuing trend of cases where patients have suffered damage to sight following cannula detachment during eye surgery.

Cannulas are used for a wide variety of reasons during ophthalmic surgery, for example, to administer anaesthetic, to irrigate fluid or air into the eye, or to aspirate fluid from the eye.

Usually, the cannula has to be attached to a syringe to administer or remove the fluid. When the syringe plunger is pressed or pulled out, a substantial force is created through the narrow diameter of the cannula. If the connection between the cannula and syringe comes loose, the cannula may detach and can cause considerable damage to the eye. The connection between the cannula and syringe must therefore be securely tightened. NHS Improvement’s report suggests that this is not always happening as it should and is creating an avoidable risk to patient safety.

Andrew Clayton of Penningtons Manches’ clinical negligence team comments: “There are known risks arising from cannula use in ophthalmic operations. Surgical staff have a duty to take reasonable steps to mitigate these risks. Patients affected by cannula detachment can suffer a devastating reduction in vision, or even total loss of sight in the affected eye.

“The trend that NHS Improvement has identified and the resulting safety alert from the Royal College of Ophthalmologists make clear that cannula detachment is happening too often. We act for a number of clients who have suffered complications during ophthalmic surgery causing permanent and wide-ranging damage affecting their domestic, social and professional lives. Cannula detachment is a known and avoidable complication in many cases and surgical teams should heed the alert to follow basic safety protocols to protect patients.”

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