Cataract surgery complications

Problems after cataract surgery these days were reduced because of the advanced cataract surgery but still there are risks for complications to happen

Complications after cataract surgery are:

2- High intraocular pressure. This is a common complication which can last for few days. During cataract surgery your eye doctor will inject visco-elastic material inside your eye to facilitate cataract extraction surgery and to protect the corneal endothelium from damage by phaco probe or the heat that is generated from the U/S probe. This I.O.P can be treated by antiglaucoma medications. In some cases in which there is no response to medications, your doctor will probably get you back to the surgery to wash out your anterior chamber and remove the visco-elastic material

3- Low intraocular pressure. It can be due to inflammation with shut down of ciliary process that is responsible for the secretion of aqueous humor. With time the inflammation will subside and the ciliary process will start to secrete aqueous again. Another cause is leakage of aqueous humor from the phaco wound and this can be treated by the use of bandage contact lens or in severe form we can add stitch to suture the wound

4- Increase in the inflammation after surgery with redness, swelling of the eyelids and ocular tenderness. This can be treated by the use of steroid eye drops

5- Endophthalmitis. For more information click here

6- Rupture of the posterior capsule with vitreous loss in the anterior chamber and drops of parts of the cataract into the vitreous. This complication will be treated by vitrectomy and removal of the cataract parts that were dropped in the vitreous and the IOL can be inserted either in the sulcus or in the anterior chamber. Sulcus is the space between the iris and the anterior capsule.

7- Retinal detachment. For more information click here

8- Choroidal hemorrhage .It is uncommon complication but it can occur. If it is localized and lies peripherally it can cause no symptoms, but id it lies in or near the macular it can cause loss of vision. Usually the treatment of it is observation and in severe cases drainage of Choroidal hemorrhage with scleral incision

9- Macular edema. Macula is the part of the retina that is responsible for central vision. Sometimes after cataract surgery this area will accumulate fluid which leads to blurring of vision for few days and sometimes for weeks. This complication can be diagnosed either clinically or by the use of OCT. There are risk factors which will increase the incidence of it which are:

1- Diabetic patients

2- Rupture of the posterior capsule and vitreous loss

It can be treated either by observation in which it will resolved by itself or by the use of steroid either by eye drops or intra-ocular steroid injection

10- Corneal edema. It is a common complication and most of the time it will be transient and after few days post surgery it will decrease and the cornea become clear again. Many factors will be responsible for it and these factors are:

1- High ultrasound time in Phacoemulsification surgery. In which there will be shutdown of the endothelium layer in the cornea that is responsible for keeping the cornea clear.

2- Old age patient in which the corneal endothelium layer is not functioning well

3- Contact between the probe of the phaco and the endothelium layer. It can be transient or permanent depend on the amount of endothelium cells damage

4- Previous corneal diseases which affect the endothelium layer Treatment of this condition is usually treated by observation. Sometimes in severe cases we can add hypertonic sodium chloride ointment to absorb fluid from the cornea. In case of chronic corneal edema, bullous keratopathy might occur, in which the cornea will become hazy and there will areas of fluid collection called bullae. The only treatment of bullous keratopathy is corneal graft surgery

11- Posterior capsular opacity or secondary cataract. This usually occurs after weeks or months of the surgery. It is common complication and sometimes its incidence is related to the type of IOL used. There will be opacity in the posterior part of the capsule or posterior part of the bag behind the IOL, which will increase gradually with time. There will be painless blurring of vision that will increase gradually. Treatment of this condition is done in the outpatient clinic with the use of laser called YAG capsulotomy laser. It is 5 minutes procedure

11- Potential for loss of vision which can be due to retinal detachment or endophthalmitis. The incidence is very low