Monday, May 5, 2014

Cataract surgery - risks and complications

Cataract Surgery Complications, Dr. M.K. Randhawa
At our Vancouver eye clinic, we manage a large number of patients with cataracts.  That includes referring them for surgery where appropriate, preparing them for surgery with medication that will make it easier for them to deal with common side effects of the surgery such as dry eye and also managing their post-operative care.

One of the most important things that eye doctors do for cataract surgery patients is explain the procedure as well as it's risks and complications. A new study published in the Canadian Journal of Ophthalmology found that some type of complication during the surgery were found in 10.35% of patients and complications arising after the procedure affected 26.63% of patients. That's a lot of patients and it highlights the need to have effective care for the patient after the surgery.

The most common complication during surgery was posterior capsule rupture (2.83%), whereas the most common postoperative complications were corneal edema (15.42%) and ocular hypertension (7.34%). These are described below.

Posterior capsule rupture

The lens of the eye is held in place by a thin membrane called the capsule. The purpose of cataract surgery is to remove the lens of the eye because it has become cloudy, causing bad vision, and then to replace it with a clear artificial lens.  Surgeons want to keep the capsule in place to hold the new artificial lens implant. If the capsule is perforated during the surgery, it is called a capsule rupture, which can lead to various complications. 

Corneal edema

The cornea is the clear dome covering the colored part of the eye.  The cornea lets light into the eye and focuses it, producing clear vision.  Sometimes the cornea swells after surgery.  This is called corneal edema and it causes cloudy vision. Other names for corneal edema after cataract surgery include “pseudophakic corneal edema,” “pseudophakic bullous keratopathy,” and “aphakic bullous keratopathy.”

Patients with corneal edema usually notice blurred vision or halos around lights. At the beginning, blurriness is often worse in the morning, but improves over the course of the day.
Ocular Hypertension

Ocular hypertension is increased pressure inside the eye.  High intra-ocular pressure can damage the optic nerve and cause permanent vision loss if not treated.


Source

Canadian Journal of Ophthalmology. Journal Canadien d'Ophtalmologie
Factors Affecting Cataract Surgery Complications and Their Effect on the Postoperative Outcome
Can J Ophthalmol 2014 Feb 01;49(1)72-79, N González, JM Quintana, A Bilbao, S Vidal, N Fernández de Larrea, V Díaz, J Gracia