Pitfalls in Ophthalmology - Corneal Transplant Mishap

By Anonymous

I was in the early days of my cornea fellowship when I was able to observe my first Boston Keratoprosthesis corneal transplant. I'm eagerly assisting when I'm asked by my chairman to punch the donor button. Determined to create the greatest donor graft in the history of cornea transplants, I line up the tissue perfectly on the block, and smash the Barron punch down with all my might. This made it difficult to get the punch off; in fact, I struggled for several seconds pulling on it. Suddenly it came off with a jolt, and the blade caught my glove. Or so I thought. As I'm calling for a new glove, the tech looks at me concerningly and says "um....Doctor, I think you need more than a glove." Confused, I look down at my hand, and am mortified to see that I'm gushing blood onto the floor. That's right, I had just trephined my own thumb.

I quickly wrap my thumb with my gown sleeve, assuring everyone I'm okay. My chairman just stares at me awestruck. It's apparent to everyone in the OR that I'm not okay. I have to hold pressure on it for fifteen minutes to get it to stop bleeding. Obviously I can't rescrub, so I just sit there & watch the rest of the surgery on TV while the resident gets to assist. The worst part of it all was we had a visiting fellow applicant there watching as well, and all I could do was look at him, nod, and give him a sad smile the entire time. The patient did receive a perfectly cut graft, and had a very successful keratoprosthesis result. I received a perfect, painful half-semicircular incision on the tip of my thumb. All in all, a great case.