Early Post-Operative Complications in Cataract Surgery

Abstract

To date a number of techniques have been used for cataract surgery. However phacoemulsification is the most common method. Other methods such as intraand extracapsular cataract extraction, mini-nuc, phacosection, sandwich and phaconit have also been used by many surgeons. Over the years, the techniques of cataract surgery have evolved into a safe and successful procedure for visual rehabilitation. The incidence of most complications has significantly decreased with better instrumentation and affordable high quality intraocular lens implants. Better pre-operative evaluation has helped. This has also reduced the number of poor results owing to the presence of other eye diseases in a patient. However some risk factors are intrinsic to the patient and, short of avoiding surgery altogether, very little can be done to eliminate them. In the event of surgery, high-risk cases should be operated on in an appropriate setting, by a surgeon who has the right level of experience. Although cataract surgery is safe for the majority of patients, some complications that involve the anterior and the posterior segment can occur. Cataract surgery complications can be divided into intraoperative complications, and postoperative complications. These complications are anaesthesia-related complications, posterior capsular rupture and vitreous loss, vitreous prolapse, expulsive haemorrhage, Descemet's membrane detachment, intraocular haemorrhage, wound malapposition, shallow anterior chamber, iris prolapse, infectious endophthalmitis, corneal oedema, dropped nucleus or retained nuclear fragments, suture-induced astigmatism, cystoid macular oedema, retinal detachment, posterior capsule opacification, and bullous keratopathy. The most important of these complications are often associated with posterior capsular rupture and infectious endophthalmitis. The incidence of posterior capsule tear during cataract surgery ranges from 0.2% to 16.0%. A higher incidence of posterior capsule tear and vitreous loss is associated with pseudoexfoliation, diabetes mellitus, trauma, hard or brunescent nuclei, and white cataract. Postoperative endophthalmitis remains a devastating outcome after cataract surgery, despite improved methods of prophylaxis, surgical technique, and treatment. This complication causes significant morbidity and distress and often severe visual impairment or blindness. The reported incidence of endophthalmitis after cataract surgery varies considerably around the world. Occurring about once every 500 operations worldwide, the relatively low incidence of endophthalmitis makes it