This document summarizes potential complications from cataract surgery, grouped into those occurring at surgery, within a week, and longer term. Complications at surgery include posterior capsule rupture, dropped nucleus, and small pupil. Within a week, potential issues are infection, high eye pressure, corneal swelling, and inflammation. Longer term risks include cystoid macular edema, retinal detachment, and unexpected conditions found on postoperative exam. The document provides examples and treatment approaches for several common complications.
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Cataract Surgery Complications and Their Management
1. B Y D N Y A N E S H W A R B P O T F O D E
Complications of Cataract Surgery
2. Time of onset of complication
1 At the time of surgery
2 Within one week of surgery
3 Longer term
3. Surgery Anaesthesia
Rupture of the posterior capsule
with vitreous loss
Dropped nucleus
Zonule dehiscence
Iris prolapse / phako damage to
iris
Small pupil
Expulsive choroidal haemorrhage
Wrong intraocular lens implant
power
Wrong concentration of
antibiotic in AC
Retrobulbar
haemorrhage
Globe perforation
Diplopia
1 Complication at the time of surgery
8. Surgery Anaesthesia
Rupture of the posterior capsule
with vitreous loss
Dropped nucleus
Zonule dehiscence
Iris prolapse / phako damage to
iris
Small pupil
Expulsive choroidal haemorrhage
Wrong intraocular lens implant
power
Wrong concentration of
antibiotic in AC
Retrobulbar haemorrhage
Globe perforation
Diplopia
1 Complications at the time of surgery
THESE PROBLEMS SHOULD HAVE BEEN MANAGED BY THE SURGEON
9. 2 Complications within one week of surgery
Infection
Postoperative raised intraocular pressure
Corneal endothelial decompensation
Refractive imbalance
Allergy to drops
10. Infection - endophthalmitis
Red eye.
Painful.
Blurred.
Hypopyon.
Urgent
treatment.
Intravitreal
Antibiotic.
Sample
vitreous
if possible.
18. 3 Longer term complications
Cystoid macular oedema
Retinal detachment
IOL subluxation
Persistent non-infective uveitis/inflammation/discomfort
Unexpected astigmatism
Other ocular conditions not found preoperatively
eg. age-related macula degeneration
19. Examination of postoperative patient
History
Visual acuity (with pinhole if needed)
Intraocular pressure
Check anterior segment with loupe and light
Dilate the pupil for fundus check
Refraction
20. Management of complications
The urgent conditions requiring immediate
treatment are:
endophthalmitis
postoperative raised intraocular
pressure/glaucoma
retinal tears/retinal detachment
All other conditions are less urgent and should be
referred back to the operating surgeon