Cataract surgery types and per, early post op and late post op complications

1. CATARACT SURGERY TYPES
AND ITS COMPLICATIONS
Presented by:
MUHAMMAD NABEEL

2. TYPES OF CATARACT SURGERY
• Intra Capsular Cataract Extraction (ICCE)
• Extra Capsular Cataract Extraction (ECCE)
• Small Incision Cataract Surgery (SCIS)
• Phacoemulsification
ECCE
ICCE

3. Intra Capsular Cataract Extraction (ICCE)

4. Extra Capsular Cataract Extraction (ECCE)

5. Small Incision Cataract Surgery (SCIS)

6. Phacoemulsification

7. COMPLICATIONS OF
CATARACT SURGERY

8. Per Operative Complications
• Bridle Suture Perforation of the globe
• Stripping of Descemet’s Membrane
• Damage to ciliary body

9. • Rupture of posterior capsule
Without vitreous loss
With vitreous loss
• Posterior loss of lens fragmentation

10. • Suprachoroidal hemorrhage
Source Long or short ciliary arteries
Contributing factors sudden rise in IOP, vitreous loss, coughing, sudden
rise in blood pressure
Signs shallowing of anterior chamber, increase IOP, iris prolapse, vitreous
extrusion, loss of red reflex, in severe cases all intra ocular contents are
extruded out
Treatment immediate, subsequent

11. Early Post-operative Complications
Iris prolapse Striate keratopathy Hyphema Wound leak

12. • Acute Bacterial Endophthalmitis
Vision threatening complication
Causative organisms most commonly staph epidermidis, staph aureus,
pseudomonas
Source air borne infections, objects, medications and solutions, tissues
Preoperative prophylaxis treatment of pre-existing infections, instillation
of povodine-iodine, meticulous draping, post operative injection of antibiotics
Time interval depends on the pathogen involved . (staph aureus 1st to 3rd
day, staph epidermidis  4th to 10th day)

13. Clinical features:
• Symptoms  Pain , redness, watering, diminished visual acuity
• Signs 

14. Management of acute bacterial endophthalmitis
• Preparation of intravitreal injections
• Identification of causative organisms
• Intravitreal injections of antibiotics
• Steroids
• Vitrectomy - only if VA is PL
• Subsequent therapy

15. Late Post-operative Complications
• Chronic endophthalmitis
Causative organisms propionibacterium acnes, staph epidermidis
Treatment steroids, antibiotics, removal of IOL and posterior capsular
bag
• Posterior capsule opacification
 Elshing pearl Capsular fibroisis
Treatment Nd:YAG laser capsulotomy

16. • Malpositioning of IOL
 Decentration Optic capture

17. • Retinal detachment
Risk factors include
• Lattice degeneration
• Disruption of posterior capsule
• Vitreous loss
• If post operative laser capsulotomy is performed
• Corneal decompensation

18. THANK YOU
ICCE