Meena Chakrabarti - Posterior Segment Complications of Cataract Surgery
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- Book:Posterior Segment Complications of Cataract Surgery
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- Publisher:Springer Nature
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- Year:2020
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This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd.
The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore
This book deals with the recognition and management of all posterior segment complications associated with cataract surgery and will provide a comprehensive coverage of these sight-threatening complications. Written for the benefit of the novice as well as experienced surgeon, each chapter is structured to offer pertinent pearls in identifying patients at risk and will emphasise on surgical strategies to be adopted to minimise the occurrence of this complication as well as management options and long-term post-operative care of these compromised eyes.
The authors who have contributed are experienced surgeons who have a long track record of successful management of these complications and are by themselves sought after teachers in this field.
Cataract surgery has evolved over the past few decades into a very safe and efficient procedure. Advances in intraocular lenses have complimented the technical surgical advances making cataract surgery a refractive procedure with excellent visual outcomes. Despite these advances in technology and techniques for safety, complications occur occasionally, even in the best of hands.
Needle stick injury
Dropped nucleus
Rhegmatogenous retinal detachment
Pseudophakic cystoid macular edema
Endophthalmitis
Toxic anterior segment syndrome
Suprachoroidal hemorrhage
Dislocated IOL
Progression of retinal disease after cataract surgery
Phototoxic retinopathy
- Needle Stick InjuryThis complication can occur if cataract surgery is planned under either peribulbar or retrobulbar anesthesia. As most cataract surgeries are currently being performed under topical anesthesia, the incidence of needle stick injury is negligible. Needle stick injury can lead to globe perforation if the sclera is injured, vascular insufficiency if the central retinal artery is damaged or toxic optic neuropathy and Purtschers like retinopathy if the optic nerve is injured during anesthesia. Risk for globe perforation is high in the following conditions:
- (a)
High myopia: Incidence of scleral perforation is estimated to be 0.13% in eyes with high myopia (axial length > 26 mm) and higher in eyes with posterior staphyloma [].
- (b)
Retrobulbar block poses greater risk compared to peribulbar block []
- (c)
Deep socket eyes with difficult access to the orbit []
- (d)
Uncooperative patient, mentally challenged, etc.
- (e)
Faulty techniques: Most common site is the inferotemporal quadrant followed by the superonasal quadrant [].
- (a)
- Dropped Nucleus: Cataract surgery leading to posterior capsular rupture (PCR) prior to segment removal carries the risk of nuclear fragments sinking into the vitreous cavity. Risk factors for dropped nucleus can be classified as under:
- (a)
Posterior polar cataract: Posterior polar cataracts are often associated with dehiscence of the central part of the posterior capsule. Forceful hydrodissection can lead to intraoperative capsular block syndrome with rupture of the dehiscent posterior capsule leading to drop of the entire nucleus [].
- (a)
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