Swelling after lens replacement. Rehabilitation after cataract removal

More detailed information about cataracts for patients and doctors (Sosnovsky V.V.)

Cataract treatment

Complications of cataract surgery

Cataract extraction surgery. performed by an experienced surgeon. is a simple, fast and safe operation. However, this does not exclude the possibility of developing a number of complications.

All complications of cataract surgery can be divided into intraoperative (occurring during surgery) and postoperative. The latter, in turn, depending on the timing of their occurrence, are divided into early and late. The incidence of postoperative complications is no more than 1-1.5% of cases.

Early postoperative complications:

inflammatory reaction (uveitis, iridocyclitis),
hemorrhage in the anterior chamber,
increase in intraocular pressure,
displacement (decentration, dislocation) of the artificial lens,
retinal detachment.

The inflammatory reaction is the eye's response to surgical trauma. In all cases, prevention of this complication begins at the final stages of the operation with the administration of steroid drugs and broad-spectrum antibiotics under the conjunctiva.

In case of an uncomplicated course of the postoperative period against the background of anti-inflammatory therapy, the symptoms of the response to surgical intervention disappear after 2-3 days: the transparency of the cornea and the function of the iris are completely restored, and ophthalmoscopy becomes possible (the fundus picture becomes clear).

Hemorrhage into the anterior chamber is a rare complication. associated with direct trauma to the iris during surgery or trauma to it by the supporting elements of the artificial lens. As a rule, during treatment, the blood resolves within a few days. If conservative therapy is ineffective, repeated intervention is performed: washing the anterior chamber, and, if necessary, additional fixation of the lens.

An increase in intraocular pressure in the early postoperative period may be associated with several reasons: “clogging” of the drainage system with viscoelastics (special viscous preparations used at all stages of the operation to protect intraocular structures, primarily the cornea) when they are not completely washed out of the eye; products of the inflammatory reaction or particles of the lens substance; development of pupillary block.

When intraocular pressure rises, drops are prescribed, treatment with which is usually effective. In rare cases, an additional operation is required - puncture (puncture) of the anterior chamber and its rinsing.

Violation of the correct position of the optical part of the artificial lens can negatively affect the functions of the operated eye. The displacement of the IOL is caused by its incorrect fixation in the capsular bag, as well as by the disproportion between the size of the capsular bag and the size of the supporting elements of the lens.

With a slight displacement (decentration) of the lens, patients complain of rapid fatigue after visual stress, double vision often appears when looking into the distance, and there may be complaints of unpleasant sensations in the eye. Complaints, as a rule, are not constant and disappear after rest. With a significant displacement of the IOL (0.7-1 mm), patients feel constant visual discomfort; there is double vision, mainly when looking into the distance. The gentle mode of visual work does not produce any effect. If such complaints develop, repeated surgery is required. consisting in correcting the position of the IOL.

Lens dislocation is a complete displacement of the IOL either posteriorly, into the vitreous cavity, or anteriorly, into the anterior chamber. Severe complication. Treatment consists of vitrectomy surgery. lifting the lens from the fundus and re-fixing it. When the lens is displaced anteriorly, the manipulation is simpler - reinserting the IOL into the posterior chamber with possible suture fixation.

Retinal detachment. Predisposing factors: myopia, complications during surgery, eye injury in the postoperative period. Treatment is most often surgical (sealing the sclera with a silicone sponge or vitrectomy). In case of local (small in area) detachment, it is possible to carry out delimiting laser coagulation of the retinal tear.

Late postoperative complications:

Secondary cataract. The capsular bag contains the artificial lens. There are numerous Elschnig balls on the posterior capsule.

“Window” in the posterior capsule of the lens after YAG laser capsulotomy

swelling of the central region of the retina (Irvine-Gass syndrome),
secondary cataract.

Swelling of the macular region of the retina is one of the complications during interventions on the anterior segment of the eye. The incidence of macular edema after phacoemulsification is significantly lower than after traditional extracapsular cataract extraction. Most often, this complication occurs between 4 and 12 weeks after surgery.

The risk of developing macular edema increases with a history of eye trauma. as well as in patients with glaucoma, diabetes mellitus, inflammation of the choroid, etc.

Secondary cataract is a fairly common late complication of cataract surgery. The reason for the formation of secondary cataracts is as follows: the cells of the lens epithelium that were not removed during the operation are converted into lens fibers (as happens during the growth of the lens). However, these fibers are functionally and structurally defective, irregular in shape, and not transparent (the so-called Adamyuk-Elschnig ball cells). When they migrate from the growth zone (equator region) to the central optical zone, a clouding is formed, a film that reduces (sometimes quite significantly) visual acuity. In addition, a decrease in visual acuity may be due to the natural process of fibrosis of the lens capsule. occurring some time after the operation.

To prevent the formation of secondary cataracts, special techniques are used: “polishing” the lens capsule in order to remove cells as completely as possible, choosing IOLs of special designs, and much more.

Secondary cataracts can form from several months to several years after surgery. Treatment involves performing a posterior capsulotomy—creating an opening in the posterior capsule of the lens. Carrying out this manipulation frees the central optical zone from opacities. allows light rays to freely penetrate into the eye. significantly improves visual acuity.

Capsulotomy can be performed by mechanically removing the film with a surgical instrument. or using a laser. The latter method is preferable because it does not involve inserting an instrument into the eye.

However, the laser method for treating secondary cataracts (YAG laser capsulotomy) also has a number of disadvantages, the key of which is the possibility of laser radiation damaging the optical part of the artificial lens. In addition, there are a number of clear contraindications to the laser procedure.

Like a surgical one. and laser capsulotomy is manipulation. carried out on an outpatient basis. Removal of secondary cataracts is a procedure that allows the patient to return high visual acuity in a few minutes, provided that the neuro-receptive apparatus of the retina and optic nerve are preserved.

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Cataract surgery is the only treatment option for cataracts

Cataract removal surgery. is one of the most common surgical interventions in general. This is the only treatment option for progressive cataracts (clouding of the lens). During a microsurgical operation. The clouded lens is removed and replaced with an artificial one. Surgical treatment of cataracts almost always provides almost complete restoration of vision.

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Cataract: definition

A cataract is a clouding of the eye lens. Like everything else in our body, the lens of the eye is also subject to the normal aging process, which leads to it becoming cloudier throughout life. This happens at each person's own pace, and certain medications, as well as smoking or eye injuries, can accelerate the process of clouding of the lens and, consequently, the onset of cataracts. Most often, this disease is caused by age, which is why it is also called senile cataract. Age-related cataracts usually occur in people over 60 years of age. Only in rare cases is it congenital.

The disease is initially perceived as a thin veil over the eyes, which becomes denser over time. People with cataracts often become more sensitive to light. Sometimes their visual acuity improves for a short time because the refraction of the eye may change. However, this positive change will be negated by clouding of the lens as the disease progresses. If the clouding of the lens progresses and visual acuity noticeably deteriorates due to this, cataract surgery is the only treatment option.

Cataract

Cataract video

Lens opacification, causes of morbidity, risk factors, treatment

A cataract is a clouding of the lens of the eye. The lens of the eye is usually clear. It acts as a biological lens, forming an important part of the light-refracting apparatus of the eye, focusing light as it passes to the back wall of the eye.

Until the age of 45, the shape of the lens of a person's eye may change. This allows the eye to focus on an object, whether close or far. As the body ages, the proteins in the lens begin to break down and it becomes cloudy. The image visible to the eye becomes blurry. This condition is known as cataract.

Causes of cataracts

Eye surgery

Too much exposure to ultraviolet light (sunlight)

In many cases, the cause of cataracts is unknown, but sometimes children are born with them, called congenital cataracts.

Symptoms of cataracts

Cataracts develop slowly and painlessly. Vision in the affected eye or eyes slowly deteriorates. Mild clouding of the lens often occurs after age 60, but does not usually cause vision problems. By age 75, most people have cataracts that impair their vision.

Visual problems may include the following changes:

Sensitivity to bright light

Loss of color intensity, colors may be less intense or yellowed

Problems perceiving shapes or differences between shades of color

Cataracts usually result in decreased vision, even in daylight. Most people with cataracts have similar changes in both eyes, although one eye may see worse than the other. Many people with this condition have only minor changes in vision.

Cataract: complications. Cataract complications

Recovery after cataract surgery is uneventful in 98% of patients. Complications, moderate to severe, are quite rare but require medical attention.

All complications of cataract surgery are divided into 2 categories: postoperative and intraoperative (those that arose during the operation).

During cataract surgery, the eye can become infected. Some infections lead to the patient losing not only vision, but also the eye itself. The risk can be minimized by using antibiotics before and during surgery. If the inflammation is external, it can be cured quickly, but if the infection develops in the eye itself, additional surgical intervention may be required.

Discharge from the incision increases the likelihood of intraocular infection. In some cases, additional stitches are necessary, but more often a pressure bandage is sufficient to promote healing.

Removing the lens and then applying too tight sutures can cause astigmatism, an abnormal curvature of the cornea. But often this illness goes away as the eye heals and the swelling subsides. In some cases, there is even a decrease in the degree of astigmatism due to a change in the curvature of the cornea of the eye.

Another possible complication of cataract surgery is bleeding inside the eye. It is rare because the cut or puncture does not affect the blood vessels. However, a bleeding choroid can cause vision loss, so this complication should be taken very seriously.

Cataract removal is also dangerous and there is a risk of increased intraocular pressure – secondary glaucoma. This disease is treated with medication, but in some isolated cases surgery is required.

Complications may appear 2-3 months after extraction. For example, the macular tissue of the retina may become inflamed. This phenomenon is called cystoid edema of the maculum. It is characterized by blurred vision and requires radical treatment methods and special analysis during examination.

Some complications may occur even a year after the operation. We are talking about retinal detachment, which can be caused by remnants of the vitreous gel.

Among the most common complications after cataract surgery is clouding of the residual membrane (the capsule left in the eye to support the artificial lens). This phenomenon is called post-cataract, but it does not mean that the cataract has formed again. This is just a clouding of the membrane surface, which can be eliminated with a laser. The procedure is quick and painless. Incomplete removal of the lens masses during cataract surgery will also lead to the same complication. In this case, the recovery period after surgery may also be accompanied by diseases such as iridocyclitis and glaucoma.

To reduce the risk of complications, the operation is performed first on one eye, and after a certain time on the other.

With a disease such as cataract, complications can arise not only after surgery, but also during the maturation of the disease. And cataracts themselves can become a complication of other diseases, for example, diabetes.

Don't underestimate the disease. Even immature cataracts can cause irreparable damage to vision. To avoid premature development of the disease, you need to carry out regular preventative care and periodically visit an ophthalmologist. And under no circumstances refuse treatment; even complicated cataracts, when the lens is removed and replaced with an artificial lens, cannot deprive a person of vision. However, the earlier treatment is started, the lower the risk of various complications. 95% of patients who decided to fight cataracts were able to regain their former visual acuity.

People who have encountered this know that in most cases you can only get rid of it . This procedure is performed by a surgeon and does not last very long.

But despite the doctor’s vast experience, there is still a possibility that vision deterioration will occur after phacoemulsification. Therefore, before going for surgery, all patients want to know what complications may occur after cataract surgery and how this can be corrected.

What are the types of complications after cataract removal?

Phacoemulsification of cataracts is a safe procedure. But despite this, complications may arise after IOL implantation. The period of their origin is both the process of surgical intervention and after some time.

Postoperative problems include:

implant displacement;
inflammatory reactions;
retinal detachment;
increased eye pressure (about normal IOP );
hemorrhage in the anterior chamber of the eye;
secondary cataract.

These complications appear in 1.5%. This means that most operations are successful and none of the above pathologies will disturb the patient.

Characteristics of early complications after surgery

Very often, patients feel discomfort after a surgical procedure and do not dare to tell the doctor about it during the examination. This causes problems that can cause significant damage to vision.

What vision problems can arise over time?

Sometimes it happens that even 3-6 months after replacing the lens, complications occur in the eye:

Even after phacoemulsification, vision problems may occur. The risk of getting them is very low. You should never remain silent about the discomfort you experience. After all, experienced specialists will help eliminate it. And then it won't arise

The cornea, the most convex part of the visual apparatus, is responsible for the light-refracting function and is an integral part of the perception of surrounding information.

Corneal edema is a common phenomenon that occurs for various reasons. With edema, the patient experiences a lot of unpleasant sensations. The surrounding objects seem blurry to him, the focus blurs. In this article, you will learn about the causes and symptoms, as well as treatment methods for corneal edema.

Definition of disease

The cornea of the eye is the main component of the refractive system. This convex-concave lens, which is no more than one millimeter thick, has 6 transparent layers.

The cornea not only refracts light, but also protects the eyes from negative external influences, for example, from dust particles floating in the air. Having high sensitivity, the cornea saves the eye from clogging by closing the eyelashes, as well as washing away particles with tear fluid. As the lesion develops, its properties change, light transmission decreases, photophobia develops, and vision decreases significantly, especially in the morning and evening hours.

As a result of the pathological process, edema in the cornea can contribute to the destruction of the substance of the corneal layer, and then to its necrosis.

Causes

The causes of corneal edema may be the following:

Symptoms

Corneal edema manifests itself in the formation of folds and vertical lines in its layers. Violation of its transparency and thickening leads to the appearance of a veil before the eyes and a decrease in visual acuity, and while wearing contact lenses a person begins to experience discomfort.

With constant and prolonged edema, the body begins to compensate for the violation by the appearance of a network of blood vessels in the cornea. At the same time, the structure of the main part of the cornea - the stroma - changes; , penetration of lipids and disruption of the transparency of the cornea occurs.

Corneal edema may be accompanied by symptoms such as:

Often, corneal edema is asymptomatic, and this pathology can only be identified by examination by an ophthalmologist.

Possible complications

If the edema is advanced and chronic, vascularization occurs, i.e., new blood vessels are formed inside the cornea. This sign can only be noticed during a biomicroscopic examination.

Corneal edema leads to a significant decrease in vision. If corneal edema becomes chronic, surgical intervention is often required.

Treatment

Therapy depends entirely on the cause that provoked the pathology. Diagnosis is carried out by an ophthalmologist. To exclude infections, laboratory tests are prescribed. The degree of corneal edema is assessed using a technique called in medicine (thickness measurement using ultrasound or optics). If necessary, the ophthalmologist can prescribe a Schirmer test, which will determine the level of tear fluid produced by the eye.

Medically

Treatment tactics with medications are selected depending on the cause that provoked corneal edema.

Reason: contact lenses

If the source of the problem is contact lenses, the first thing to do is stop using them until the symptoms disappear completely.

Bacterial infection often results from improper lens wear. Corneal edema is provoked by bacteria such as Staphylococcus aureus, Pseudomonas aeruginosa, and amoebic infection.

Treatment in this case consists of local use of antibacterial agents., such as , . The antibiotics contained in these drugs will quickly and effectively help the patient.

Levofloxacin is used for corneal edema

Cause – complication after cataract surgery

Corneal edema after cataract surgery sometimes occurs the next day after the procedure. The cause of swelling in this case is the large amount of fluid that passes through the eye during crushing and washing out the replaced lens of the eye. The denser the cataract and the poorer the vision, the more likely it is to develop postoperative corneal edema.

As a rule, corneal edema after surgery does not require additional treatment. Disappears on its own within 1-2 weeks.

In rare cases, swelling is relieved with injections and procedures, which, if necessary, are prescribed by the attending physician.

Infections

Treatment of infectious diseases that cause corneal edema requires antifungal or. Local remedies (eye drops) are usually used, but for more severe conditions, tablets or intravenous injections are prescribed.

For viral diseases drugs containing interferon (for example), as well as artificial tears are used.

Oftalmoferon is used for viral diseases of the cornea

For bacterial infections antibacterial agents are indicated (Moxifloxacin, Levofloxacin).

Moxifloxacin is used for bacterial infections

Allergic reaction

To relieve allergic corneal edema, the first step is to identify and eliminate contact with the allergen (cosmetics, dust, animal hair, pollen, perfumes). To relieve symptoms, you should take an antihistamine (Diazolin, Suprastin, Diphenhydramine).

Diazolin is an antihistamine

Corneal edema after injury

Corneal injury is a fairly common occurrence.. A minor injury does not require treatment. If the damage is significant, then a doctor should be called immediately. Before help arrives, you need to blink frequently (if the foreign body does not interfere with this) and rinse your eye with clean water.

If you are injured, do not rub your eyelids with your fingers, and do not pull out a foreign body stuck into your eye yourself.

Surgically

If conservative treatment methods do not help, the doctor may recommend surgery. In case of abnormalities in the cornea, a corneal transplant is performed, and in some modern clinics, the cornea is densified with ultraviolet light.

Folk remedies

For inflammation and swelling in the eye, you can use traditional medicine recipes as an additional treatment. Below are the most popular recipes:

Prevention

Preventive measures against corneal edema:

Compliance with hygiene rules when caring for your face;
Using hypoallergenic high-quality cosmetics;
Regular measurement of intraocular pressure in patients over 45 years of age;
Protect your eyes with special glasses to avoid injury to the organ of vision and the appearance of symptoms of swelling during hazardous work.

The correct selection of contact optics plays an important role in the prevention of pathological conditions of the corneal layer. Lenses must be of high quality, allowing oxygen to pass through to the eyes. You need to use lenses correctly.

Select cosmetics for eyelids and eyelashes from a health safety point of view; they should not contain allergens that cause swelling.

After removal of cataracts, glaucoma and other surgical interventions in different parts of the eye, do not burden your visual organs with computer work or reading, so as not to cause a relapse.

You need to choose a job that does not require strong physical activity or bending. When sleeping, you need to lie down so that your head is higher than your feet, which will ensure the necessary outflow of blood.

After treatment of edema, it is prohibited to go swimming or go to the sauna.

If you follow these rules, you can avoid repeated swelling of the cornea.

Video

Conclusions

The most common type of corneal edema is edema, which has a variety of origins. It is very important to establish the cause of the swelling condition with the help of medical diagnosis, after which it is possible to carry out treatment aimed at effectively eliminating the cause of the disease.

Classmates

Cataract is clouding of the lens of the eye. In most cases, the disease is caused by the natural aging process of the body, but it is also observed in people who have sustained an eye injury, have diabetes, and can also be a consequence of radiation therapy.

Cataract surgery is safe and quick in most cases, especially when performed by a highly qualified specialist. However, there are cases when complications arise during, and more often after, surgery.

Complications after cataract removal are divided into 2 types:

In turn, each type includes different types of complications. So they attribute to the early ones:

inflammatory reactions. These include uveitis (inflammation of the vascular system of the eye) and iridocyclitis (inflammation of the iris and ciliary body of the eye). This reaction is a completely normal response of the body to the injury that occurred during the operation. If the postoperative period proceeds without complications, then the inflammatory process will go away on its own in a couple of days and the eye will return to its original state.
rise in intraocular pressure. Associated with clogged drainage system of the eye. Most often it is eliminated by prescribing drops to the patient; in some cases it is treated with punctures.
hemorrhage in the anterior chamber. It occurs extremely rarely if the iris of the eye is affected.
retinal detachment. Most often observed with myopia or surgical injuries, it is treated with repeated intervention.
displacement of the artificial lens. The displacement is caused by improper attachment in the capsular bag or incompatibility of the bag with the lens. Corrected by repeated surgery.

Late complications after cataract removal are:

secondary cataract. A frequently observed late complication that occurs after surgery. It occurs due to the fact that incompletely removed epithelial cells continue their development further, transforming into lens fibers. After they move to the central optical zone, clouding occurs, reducing vision. It can be treated with simple surgery or laser.
swelling of the macular region of the retina. The second name is Irvine-Gass syndrome. It is an accumulation of fluid in the macula of the eye (macula), leading to decreased central vision. It is treated with laser or conventional surgery, as well as a course of medication.

Possible complications after cataract surgery

More than 98% of patients have improved vision after surgery. if there were no concomitant eye diseases. Recovery is proceeding smoothly. Moderate or severe complications are extremely rare but require immediate medical attention.

Eye infections After cataract surgery, they are very rare - one case in several thousand. But if the infection develops inside the eye, you can lose your vision and even your eye.

Most ophthalmologists use antibiotics before, during, and after cataract surgery to minimize the risk. External inflammation or infections usually respond well to medication. However, infection can develop in the eye very quickly, even within a day after surgery, and in such cases immediate treatment is required.

Intraocular inflammation (swelling at the incision site) that occurs in response to surgery is usually a minor reaction in the postoperative period.

Small discharge from a cut on the cornea is rare, but can create a high risk of intraocular infection and other unpleasant consequences. If this occurs, your doctor may recommend using a contact lens or apply a pressure bandage to the eye to promote healing. But sometimes additional stitches are needed to close the wound.

Some people may develop severe astigmatism, an abnormal curvature of the cornea that causes blurred vision, after surgery due to inflammation of the tissue or too tight sutures. But when the eye heals after surgery, the swelling goes down and the stitches are removed, the astigmatism usually corrects itself. In some cases, cataract removal can reduce pre-existing astigmatism because the incisions can change the shape of the cornea.

Bleeding inside the eye is another possible complication. It occurs quite rarely, since small incisions are made in the eye exclusively on the cornea and do not affect the blood vessels inside the eye. By the way, even bleeding caused by large incisions can stop on its own without causing any harm. Bleeding from the uvea—the thin membrane in the middle layer of the eye, between the sclera and retina—is a rare but serious complication that can cause complete loss of vision.

Another possible complication after cataract surgery is secondary glaucoma - increased intraocular pressure. It is usually temporary and can be caused by inflammation, bleeding, adhesions, or other factors that increase intraocular (in the eyeball) pressure. Drug treatment for glaucoma usually helps regulate blood pressure, but sometimes laser treatment or surgery is required. Retinal detachment is a serious condition in which the retina separates from the back wall of the eye. Although this occurs infrequently, it requires surgical intervention.

Sometimes 1-3 months after cataract surgery, the macular tissue of the retina becomes inflamed. This condition is called cystoid macula edema. characterized by blurred central vision. With the help of a special analysis, an ophthalmologist can make a diagnosis and administer medication. In rare cases, the implant may move. In this case, blurred vision, bright double vision, or blurred vision may occur. If this interferes with your vision, your ophthalmologist may replace or replace the implant.

In 30-50% of all cases, the residual membrane (the capsule left in the eye to support the implant) becomes cloudy some time after surgery, causing blurred vision. It is often called secondary, or post-cataract, but this does not mean that the cataract has formed again; this is only a clouding of the membrane surface. If this condition interferes with clear vision, it can be corrected with a procedure called YAG (yttrium aluminum garnet) capsulotomy. During this procedure, the ophthalmologist uses a laser to create holes in the center of the cloudy membrane to allow light to pass through. This can be done quickly and painlessly, without incisions.

Complications After Cataract Surgery

Types of complications

increase in intraocular pressure;
uevitis, iridocyclitis – inflammatory eye reactions;
retinal detachment;
hemorrhage in the anterior chamber;
displacement of the artificial lens;
secondary cataract.

Retinal detachment

Full Lens Shift

Secondary cataract

Possible complications

The most common complication of lens replacement surgery. Secondary cataract is expressed as opacification of the posterior capsule. It was revealed that the frequency of its development depends on the material from which the artificial lens is made. For example, polyacrylic IOLs cause it in 10% of cases, and silicone lenses - in almost 40%; there are also lenses made of polymethyl methacrylate (PMMA), the frequency of this complication for them is 56%. The causes that provoke the occurrence of secondary cataracts, as well as effective methods for its prevention, are still not fully understood.

It is generally accepted that this complication is caused by migration of the lens epithelium into the space between the lens and the posterior capsule. Lens epithelium is the cells remaining after lens removal that contribute to the formation of deposits that significantly impair image quality. Another possible cause is fibrosis of the lens capsule. Elimination of such a defect is carried out using a YAG laser, which is used to create a hole in the center of the area of the clouded posterior lens capsule.

This is a complication of the early postoperative period. It may be caused by incomplete washout of viscoelastic, a special gel-like drug that is injected into the anterior chamber to protect the structures of the eye from surgical damage. In addition, the cause may be the development of pupillary block if there is a displacement of the IOL towards the iris. Elimination of this complication does not take much time; in most cases, taking antiglaucoma drops for several days is enough.

Cystoid macular edema (Irvine-Gass syndrome)

A similar complication occurs after phacoemulsification of cataracts in approximately 1% of cases. While the extracapsular method of lens removal makes it possible for the development of this complication in almost 20% of operated patients. People with diabetes, uveitis, or wet AMD are most at risk. In addition, the incidence of macular edema increases after cataract extraction, which is complicated by rupture of the posterior capsule or loss of the vitreous. Treatment is carried out with corticosteroids, NSAIDs, angiogenesis inhibitors. If conservative treatment is ineffective, vitrectomy may sometimes be prescribed.

A fairly common complication of cataract removal. The reasons are a change in the pumping function of the endothelium, which occurred due to mechanical or chemical damage during surgery, an inflammatory reaction or concomitant ocular pathology. As a rule, swelling goes away within a few days, without treatment. In 0.1% of cases, pseudophakic bullous keratopathy may develop, accompanied by the formation of bullae (vesicles) in the cornea. In such cases, hypertonic solutions or ointments are prescribed, medicinal contact lenses are used, and therapy is carried out for the pathology that caused this condition. Lack of treatment effect may result in corneal transplantation.

A very common complication of IOL implantation, leading to a deterioration in the outcome of the operation. Moreover, the amount of induced astigmatism is directly related to the method of cataract extraction, the length of the incision, its location, the presence of sutures, and the occurrence of any complications during the operation. Correction of small degrees of astigmatism is carried out with spectacle correction or using contact lenses; with severe astigmatism, refractive surgery is possible.

Displacement (dislocation) of the IOL

A rather rare complication compared to those described above. Retrospective studies have found that the risks of IOL dislocation in operated patients 5, 10, 15, 20 and 25 years after implantation are 0.1, 0.2, 0.7 and 1.7%, respectively. It has also been found that pseudoexfoliation syndrome and laxity of the zonules of Zinn can increase the likelihood of lens displacement.

IOL implantation increases the risk of rhegmatogenous retinal detachment. As a rule, patients with complications that arose during surgery, those who injured the eye during the period after surgery, those with myopic refraction, and diabetics are exposed to this risk. In 50% of cases, such a detachment occurs in the first year after surgery. Most often it occurs after intracapsular cataract extraction surgery (in 5.7% of cases), least often after extracapsular cataract extraction surgery (in 0.41-1.7% of cases) and phacoemulsification (in 0.25-0.57% of cases). cases). All patients with implanted IOLs should continue to be followed by an ophthalmologist to ensure that this complication is detected as early as possible. The principle of treatment for this complication is the same as for detachments of other etiologies.

Very rarely, during cataract surgery, choroidal (expulsive) bleeding occurs - an acute condition that is absolutely impossible to predict in advance. When it occurs, bleeding develops from the damaged choroidal vessels, which lie under the retina, feeding it. Risk factors for the development of such conditions are arterial hypertension, a sudden increase in IOP, atherosclerosis, aphakia, glaucoma, axial myopia, or, conversely, a small anteroposterior size of the eyeball, taking anticoagulants, inflammation, and old age.

Often it stops on its own, with virtually no effect on visual functions, but sometimes its consequences can even lead to the loss of an eye. The main treatment is complex therapy, including the use of local and systemic corticosteroids, drugs with cycloplegic and mydriatic effects, and antiglaucoma drugs. In some cases, surgery is indicated.

Endophthalmitis is also a fairly rare complication in cataract surgery, which can lead to a significant decrease in vision, up to its complete loss. The frequency of its occurrence can be 0.13 - 0.7%.

The risk of developing endophthalmitis may increase if the patient has blepharitis, conjunctivitis, canaliculitis, obstruction of the nasolacrimal ducts, entropion, when using contact lenses, a prosthesis of the fellow eye, or after immunosuppressive therapy. Signs of an intraocular infection may include: severe redness of the eye, increased sensitivity to light, pain, and decreased vision. Prevention of endophthalmitis - instillation of 5% povidone-iodine before surgery, administration of antibacterial agents inside the chamber or subconjunctivally, sanitation of possible foci of infection. It is especially important to use disposable or thoroughly treat reusable surgical instruments with disinfectants.

Advantages of treatment at MGK

Almost all of the above complications of cataract surgical treatment are poorly predictable and are often associated with circumstances beyond the surgeon’s skill. Therefore, it is necessary to treat the complication that has arisen as an inevitable risk that is inherent in any surgical intervention. The main thing in such circumstances is to get the necessary help and adequate treatment.

By using the services of specialists from the Moscow Eye Clinic, you can be sure that you will receive all the necessary assistance in full, regardless of the location of the operation that caused the complication. Our patients have the latest diagnostic and surgical equipment, the best ophthalmologists and ophthalmic surgeons in Moscow, and attentive medical staff at their disposal. The clinic’s specialists have accumulated sufficient experience in effectively treating complications of cataract surgery. The clinic has a comfortable 24-hour hospital. We work for you all week, seven days a week, from 9.00 to 21.00 Moscow time.

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An increase in intraocular pressure in the postoperative period may occur due to: the development of pupillary block, or clogging of the drainage system with special viscous preparations - highly elastic, used at all stages of the operation to protect intraocular structures and, especially, the cornea of the eye, if they are incompletely washed out of the eye In this case, when intraocular pressure rises, drops are prescribed, and this is usually sufficient. Only in rare cases, when intraocular pressure increases in the early postoperative period, an additional operation is performed - puncture (puncture) of the anterior chamber and its thorough washing. Retinal detachment occurs with the following predisposing factors:

myopia,

Cataract surgery performed by a professional surgeon does not take much time and is considered a completely safe procedure. But even a specialist’s extensive experience does not exclude the development of complications after eye cataract surgery, because Any surgical intervention carries a certain degree of risk.

Types of pathologies after surgery

After surgery, doctors divide the negative results of the operation into two components:

Intraoperative – occur during the work of surgeons.
Postoperative – develop after surgery and, depending on the time of their occurrence, are divided into early and late.

The risk of complications after cataract surgery occurs in 1.5% of cases.

Postoperative complications are represented by the following types:

The inflammatory response is the reaction of eye tissue to intervention. At the final stages of the operation, doctors administer anti-inflammatory drugs (antibiotics and steroids) that have a wide spectrum of action.

Intraocular bleeding after cataract surgery occurs in rare cases. An incision is made on the cornea, where there are no blood vessels. If bleeding occurs, it can be assumed that it occurs on the surface of the eye. The surgeon cauterizes the area, stopping it.

The early period after cataract surgery is usually characterized by an increase in intraocular pressure. The reason for this is insufficient leaching of the vicoelastic. This is a gel-like drug that is injected inside in front of the camera of the eye, it should protect the eyes from damage. In order to relieve pressure, it is enough to take anti-glaucoma drops for several days.

Such a complication after cataract surgery as lens dislocation is less common. Studies show that the risk of this phenomenon in patients 5, 10, 15, 20 and 25 years after surgery is small. For patients with severe myopia, the risk of getting retinal detachment in the surgical department is quite high.

Postoperative complications

Swelling of the central zone of the retina.
Cataract (secondary).

The most common complication is clouding of the posterior capsule of the lens of the eye or a variant of “secondary cataract”. The frequency of its occurrence is directly dependent on the lens material. For polyacrylic it is approximately 10%. For silicone – 40%. For PMMA material – more than 50%.

Secondary cataract as a complication after surgery may not occur immediately, but several months after the intervention. Treatment in this case consists of capsulotomy - this is the creation of a hole in the lens capsule located at the back. Thanks to this, the eye surgeon frees the optical zone in the eye from clouding processes, allows light to freely penetrate into the eye and increase the acuity of visual perception.

Swelling characteristic of the macular zone of the retina is also a pathology that is typical during operations in the anterior area of the eye. This complication can occur from 3 to 13 weeks after the end of the surgical intervention.

The likelihood of developing a problem such as macular edema increases if the patient has had an eye injury in the past. In addition, there is an increased risk of swelling after surgery in people suffering from glaucoma, high blood sugar and inflammatory processes occurring in the choroid.

Cataracts are a common eye disease caused by clouding of the lens. Causes visual impairment. The disease is typical for older people, usually after 60 years. But there are cases of cataracts appearing at an earlier age.

Cataracts belong to the category of ophthalmological diseases, which is characterized by a decrease in the quality of vision as a result of clouding of the lens and its capsule. Requires urgent treatment as it can cause complete loss of vision.

One of the common eye diseases is cataracts. Most often it occurs in older people.

The modern ophthalmological market is replete with intraocular lenses from various manufacturers. The cost of IOLs also varies significantly. For an ordinary person who does not know which lens is better for cataracts, such diversity becomes a cause of doubt.

Surgical removal of cataracts is a highly effective, but rather complex and expensive operation, the risk of complications after which is relatively high. Complications after cataract surgery occur, as a rule, in those patients who have concomitant diseases or do not comply with the rehabilitation regimen. In addition, the development of complications may result from a medical error.

Common complications are described below.

Eye watering

Excessive tearing may result from infection. Infection in the eye during surgery is practically excluded due to sterility. However, failure to follow the doctor's recommendations in the postoperative period (washing with running water, constantly rubbing the eye, etc.) can lead to infection. In this case, antibacterial drugs are used.

Redness of the eye

Redness of the eye can be both a sign of infection and a symptom of a more serious complication - hemorrhage. Hemorrhage into the eye cavity can occur during surgery for traumatic cataracts and requires immediate assistance from a specialist.

Corneal edema

Consequences of cataract surgery may include corneal swelling. A mild degree of swelling is quite common and most often appears 2-3 hours after surgery. Most often, mild swelling resolves on its own, but to speed up the process, the doctor may prescribe eye drops. During swelling, vision may be blurry.

Eye pain

In some cases, intraocular pressure increases after cataract removal. Most often this occurs due to the use of a solution during surgery that cannot pass normally through the drainage system of the eye. Increased pressure manifests itself as pain in the eye or headache. As a rule, increased intraocular pressure is treated with medication.

Retinal detachment

Consequences after cataract removal include such a serious complication as retinal detachment. At risk are patients with myopia (myopia). According to research, the incidence of retinal detachment is about 3-4%.

A fairly rare complication is displacement of the implanted intraocular lens. Often this complication is associated with a rupture of the posterior capsule, which holds the lens in the correct position. The displacement can manifest itself as flashes of light before the eyes or, on the contrary, darkening in the eyes. The most striking manifestation is “double vision” in the eyes. With strong displacement, the patient can even see the edge of the lens. If these symptoms appear, you should consult a doctor as soon as possible. The displacement is eliminated by “suturing” the lens to the capsule that holds it. In case of prolonged displacement (more than 3 months), the lens may become scarred, which will subsequently complicate its removal.

Endophthalmitis

A fairly serious complication of cataract surgery is endophthalmitis - extensive inflammation of the tissues of the eyeball. Advanced endophthalmitis can cause vision loss, so treatment should never be delayed. The average incidence of endophthalmitis after cataract removal is about 0.1%. At risk are patients with thyroid diseases and weakened immune systems.

Opacification of the lens capsule

Complications after cataract removal include clouding of the posterior capsule of the lens. The reason for the development of this complication is the “growth” of epithelial cells on the posterior capsule. This complication can lead to deterioration of vision and a decrease in its acuity. Posterior capsule opacification is quite common - in 20-25% of patients who have undergone cataract removal. Treatment for opacification of the posterior capsule is surgical, and is carried out using a YAG laser, which “burns out” the growths of epithelial cells on the capsule. The procedure is painless for the patient, does not require anesthesia, and instillation of anti-inflammatory drops is recommended after it. After laser therapy, the patient can immediately return to their normal rhythm of life. Sometimes after the procedure there is blurred vision, which disappears fairly quickly.

People who have had to deal with such an ophthalmological problem as lens opacity know that the only way to get rid of it is cataract surgery, that is, IOL implantation. In the United States, more than 3 million such operations are performed per year, and 98% of them are successful. In principle, this operation is simple, quick and safe, but it does not exclude the development of complications. What complications may arise after cataract surgery and how to correct them, we will find out by reading this article.

All complications that accompany IOL implantation can be divided into those that occurred directly during surgery or postoperatively. Postoperative complications include:

increase in intraocular pressure; uevitis, iridocyclitis - inflammatory ocular reactions; retinal detachment; hemorrhage in the anterior chamber; displacement of the artificial lens; secondary cataract.

Inflammatory eye reactions

Inflammatory responses almost always accompany cataract surgery. That is why, immediately after the completion of the intervention, steroid drugs or broad-spectrum antibiotics are injected under the conjunctiva of the patient’s eye. In most cases, symptoms of the response will completely disappear after about 2-3 days.

Hemorrhage into the anterior chamber

This is a fairly rare complication that is associated with trauma or damage to the iris during surgery. Usually the blood resolves on its own within a few days. If this does not happen, doctors rinse the anterior chamber and, if necessary, additionally fix the lens of the eye.

Increase in intraocular pressure

This complication may occur due to clogging of the drainage system with highly elastic, viscous drugs that are used during surgery to protect the cornea and other intraocular structures. Usually, instilling drops that reduce intraocular pressure solves this problem. In exceptional cases, it becomes necessary to puncture the anterior chamber and thoroughly rinse it.

Retinal detachment

This complication is considered severe, and it occurs in the event of an eye injury after surgery. In addition, retinal detachment is most common in people with myopia. In this case, ophthalmologists most often decide to perform an operation, which consists of filling the sclera - vitrectomy. In the case of a small area of detachment, restrictive laser coagulation of the retinal tear can be performed. Among other things, retinal detachment leads to another problem, namely lens displacement. Patients begin to complain about rapid eye fatigue, pain, and double vision when looking into the distance. These symptoms are not permanent and usually disappear after a short rest. When a significant displacement occurs (1 mm or more), the patient feels constant visual discomfort. This problem requires repeated intervention.

Full Lens Shift

Dislocation of the implanted lens is considered the most severe complication, which requires unconditional surgical intervention. The operation involves lifting the lens and then fixing it in the correct position.

Secondary cataract

Another complication after cataract surgery is the formation of secondary cataracts. It occurs due to the proliferation of remaining epithelial cells from the damaged lens, which spread to the area of the posterior capsule. The patient experiences deterioration in vision. To correct this problem, it is necessary to undergo a laser or surgical capsulotomy procedure. Take care of your eyes!

Posterior capsule rupture

This is a fairly serious complication, as it may be accompanied by loss of the vitreous body, posterior migration of the lens masses and, less commonly, expulsive bleeding. If not treated appropriately, long-term consequences of vitreous loss include a pulled-up pupil, uveitis, vitreous opacities, wick syndrome, secondary glaucoma, posterior dislocation of the artificial lens, retinal detachment, and chronic cystoid macular edema.

Signs of posterior capsule rupture

Sudden deepening of the anterior chamber and instantaneous dilatation of the pupil. Failure of the nucleus, inability to pull it to the tip of the probe. Possibility of vitreous aspiration. The ruptured capsule or vitreous body is clearly visible.

Tactics depend on the stage of the operation at which the rupture occurred, its size and the presence or absence of vitreous prolapse. The basic rules include:

introduction of viscoelastic behind the nuclear masses in order to bring them into the anterior chamber and prevent vitreous hernia; insertion of a special gland behind the lens masses to close the defect in the capsule; removal of lens fragments by introducing viscoelastic or removing them using phaco; complete removal of the vitreous from the anterior chamber and the incision area using a vitreotome; The decision to implant an artificial lens should be made taking into account the following criteria:

If large quantities of lens masses have entered the vitreous cavity, an artificial lens should not be implanted, as it may interfere with fundus visualization and successful pars plana vitrectomy. Artificial lens implantation can be combined with vitrectomy.

If there is a small tear in the posterior capsule, careful implantation of a CD-IOL into the capsular bag is possible.

In case of a large tear and especially with an intact anterior capsulorhexis, it is possible to fix the CB-IOL in the ciliary groove with the optical part placed in the capsular bag.

Insufficient capsule support may necessitate sulcus suturing of the intraocular lens or implantation of a glide-assisted PC IOL. However, PC IOLs are associated with more complications, including bullous keratopathy, hyphema, iris folds, and pupil irregularity.

Dislocation of lens fragments

Dislocation of lens fragments into the vitreous body after rupture of the zonular fibers or posterior capsule is a rare but dangerous phenomenon, as it can lead to glaucoma, chronic uveitis, retinal detachment and chronic cystoid macular edema. These complications are more often associated with phaco than with EEC. Initially, treatment for uveitis and glaucoma must be carried out, then the patient should be referred to a vitreoretinal surgeon for vitrectomy and removal of lens fragments.

NB: There may be cases where it is not possible to achieve the correct position even for a PC IOL. Then it is safer to refuse implantation and decide to correct aphakia with a contact lens or secondary implantation of an intraocular lens at a later date.

The timing of the operation is controversial. Some suggest removing residues within 1 week, since later removal affects the restoration of visual function. Others recommend postponing surgery for 2-3 weeks and undergoing treatment for uveitis and increased intraocular pressure. Hydration and softening of the lens masses during treatment facilitates their removal using a vitreotome.

Surgical techniques include pars plana vitrectomy and removal of soft fragments with a vitreotome. More dense fragments of the nucleus are connected by the introduction of viscous liquids (for example, perfluorocarbon) and further emulsification with a phragmatome in the center of the vitreous cavity or removal through a corneal incision or scleral pocket. An alternative method for removing dense nuclear masses is their crushing followed by aspiration,

Dislocation of the GK-IOL into the vitreous cavity

Dislocation of the GC IOL into the vitreous cavity is a rare and complex phenomenon, indicating improper implantation. Leaving an intraocular lens in place can lead to vitreal hemorrhage, retinal detachment, uveitis, and chronic cystoid macular edema. Treatment is vitrectomy with removal, reposition or replacement of the intraocular lens.

With adequate capsular support, repositioning of the same intraocular lens into the ciliary sulcus is possible. With inadequate capsular support, the following options are possible: removal of the intraocular lens and aphakia, removal of the intraocular lens and replacing it with a PC-IOL, scleral fixation of the same intraocular lens with a non-absorbable suture, implantation of iris-clip lenses.

Hemorrhage into the suprachoroidal space

Hemorrhage into the suprachoroidal space may be a consequence of expulsive bleeding, sometimes accompanied by prolapse of the contents of the eyeball. This is a serious but rare complication and is unlikely to occur with phacoemulsification. The source of hemorrhage is a rupture of the long or posterior short ciliary arteries. Contributing factors include advanced age, glaucoma, anterior-posterior enlargement, cardiovascular disease, and vitreous loss, although the exact cause of bleeding is not known.

Signs of suprachoroidal hemorrhage

Increasing fragmentation of the anterior chamber, increased intraocular pressure, iris prolapse. Leakage of the vitreous body, disappearance of the reflex and the appearance of a dark tubercle in the pupil area. In acute cases, the entire contents of the eyeball may leak through the incision area.

Immediate actions include closing the incision. Posterior sclerotomy, although recommended, may increase bleeding and lead to loss of the eye. After surgery, the patient is prescribed local and systemic steroids to relieve intraocular inflammation.

Ultrasound examination is used to assess the severity of changes that have occurred; surgery is indicated 7-14 days after blood clots have liquefied. The blood is drained and vitrectomy is performed with air/fluid exchange. Despite the unfavorable prognosis for vision, in some cases it is possible to preserve residual vision.

The swelling is usually reversible and is most often caused by the operation itself and injury to the endothelium through contact with instruments and the intraocular lens. Patients with Fuchs endothelial dystrophy pose an increased risk. Other causes of edema are the use of excessive power during phacoemulsification, complicated or prolonged surgery, and postoperative hypertension.

Iris prolapse

Iris prolapse is a rare complication of small incision surgery but can occur with EEC.

Causes of iris loss

The incision for phacoemulsification is closer to the periphery. Moisture leaking through the cut. Poor suture placement after EEC. Patient-related factors (cough or other strain).

Symptoms of iris loss

On the surface of the eyeball in the area of the incision, prolapsed iris tissue is detected. The anterior chamber at the incision site may be shallow.

Complications: uneven wound scarring, severe astigmatism, epithelial ingrowth, chronic anterior uveitis, macular edema and endophthalmitis.

Treatment depends on the interval between surgery and detection of prolapse. If the iris falls out within the first 2 days and there is no infection, its reposition with repeated suturing is indicated. If the prolapse occurred a long time ago, the area of the prolapsed iris is excised due to the high risk of infection.

Intraocular lens displacement

Displacement of the intraocular lens is rare, but can be accompanied by both optical defects and disturbances in the structures of the eye. When the edge of the intraocular lens is displaced into the pupil area, patients are bothered by visual aberrations, glare and monocular diplopia.

Intraocular lens displacement mainly occurs during surgery. It can be caused by dialysis of the ligament of Zinn, capsule rupture, and can also occur after conventional phacoemulsification, when one haptic part is placed in the capsular bag and the second in the ciliary groove. Postoperative causes include trauma, irritation of the eyeball and contraction of the capsule.

Treatment with miotics is beneficial for minor displacement. Significant displacement of the intraocular lens may require replacement.

Rheumatogenous retinal detachment

Rheumatogenous retinal detachment, although rare after EEC or phacoemulsification, may be associated with the following risk factors.

Lattice degeneration or retinal breaks require pretreatment before cataract extraction or laser capsulotomy if ophthalmoscopy is possible (or immediately after it becomes possible). High myopia.

During surgery

Vitreous loss, especially if subsequent management was incorrect, and the risk of detachment is about 7%. If myopia is >6 diopters, the risk increases to 1.5%.

Performing YAG laser capsulotomy in the early stages (within a year after surgery).

Cystoid retinal edema

Most often it develops after a complicated operation, which was accompanied by rupture of the posterior capsule and prolapse, and sometimes strangulation of the vitreous, although it can also be observed during a successfully performed operation. Usually appears 2-6 months after surgery.

When cataracts appear and progress, doctors advise immediate surgery to replace the lens. Elderly people or people with chronic diseases may face a similar problem. If you do not seek qualified help in a timely manner, there is a risk of losing your vision forever.

An operation to replace the lens of the eye requires compliance with certain conditions during the rehabilitation period, which can last several months. This article talks about how to behave at this time and what can result from failure to comply with the established rules.

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The essence of the operation

Each operation is a technically complex surgical intervention. If we are talking about replacing the lens, then the patient will need to undergo phacoemulsification - a high-tech technique of sutureless surgery, in which the lens is placed in the eyeball using a micro-incision, and the cataract is crushed with a laser.

Lens replacement is most often required by an elderly person whose vision has become blurry and unclear. In addition, the patient may develop and progress into farsightedness or nearsightedness.

There is a certain scheme of actions that doctors adhere to when performing an operation. It consists of the following steps:

Through a self-sealing incision, doctors use a laser to transform the damaged lens into an emulsion.
The remaining lens is removed using suction.
An elastic artificial lens is placed in the eyeball, which independently expands on the eye.
The procedure is performed under local anesthesia in a hospital setting. It lasts no longer than an hour, depending on how advanced the cataract is and how densely the lens is clouded.

The operation has a large number of advantages. Here are some of them:

Well tolerated at any age.
Does not cause pain to the patient.
Does not require any serious restrictions during the rehabilitation period.
Does not leave seams.
Involves the use of safe materials and high quality tools.

All these advantages over outdated techniques make it possible to perform an operation called phacoemulsification in the shortest possible time with a minimum of complications.

Despite the use of the latest technologies, the procedure has several contraindications:

Inflammatory process in the eyes.
The anterior chamber of the eyeball is too small.
Retinal pathology: destruction or detachment.
Recent stroke or heart attack.

Features of the postoperative period

Rehabilitation after lens replacement can take place in the shortest possible time, or it can take a long time. It all depends on the patient himself and on the qualifications of the attending physician.

After phacoemulsification, an operation to replace the lens for cataracts, has been performed, the person must remain under the supervision of the attending physician for some time. The process is completed quite quickly, so the patient is allowed to move and get out of bed after 20 - 40 minutes, and if there are no signs of complications, then after 2 hours he can go home.

A repeat visit to the specialist should be made one day after the operation. Further similar examinations are carried out daily for about two weeks.

After replacing the lens for cataracts, a person is given a protective bandage that prevents contamination from entering the eye, leading to infection. It is allowed to remove such a bandage only one day after surgery. After which the eye should be treated with a cotton swab soaked in a solution of chloramphenicol or furatsilin, without lifting the eyelid.

For the first few days, a person should not leave the house unless absolutely necessary. If it is not possible to comply with this condition, then you should again cover your eye with a bandage that prevents blinking. In cases where the healing process is active, you can use protective glasses instead of a bandage.

The cut on the eyes finally heals after 7 days. During this week, a person should not wash his hair or take a shower. In addition, drinking alcohol and carbonated drinks is prohibited. After your eyes stop hurting and the clouding disappears, you can watch TV and read newspapers. But you should stop if your eyes start to get tired. To reduce the load, doctors prescribe special drops that have a disinfectant and anti-inflammatory effect.

Although patients note an immediate improvement in vision after lens replacement surgery, the eyes are completely restored only after 2 to 3 months.

During this period, it is very important not to strain your eyesight and avoid heavy loads. If you follow all the doctor’s instructions, you don’t have to worry about possible complications and very soon return to pre-operative life.

Lens clouding - symptoms and treatment of the disease

Rehabilitation period

The duration of rehabilitation directly depends on the type of intervention performed. People who have undergone ultrasound or laser phacoemulsification return to normal the fastest.

The rehabilitation period consists of several phases. It's worth considering each of them.

First phase: 1 – 7 days after surgery.

This stage is characterized by pain of various types both in the eye itself and around it. This symptom can be successfully relieved with the help of a non-steroidal anti-inflammatory drug in the dosage prescribed by the attending physician. It is possible to take painkillers.

In addition to pain, patients experience swelling of the eyelids. This phenomenon does not require medication, but can be relieved by limiting drinking, correct posture during sleep and reviewing the diet.

Second phase: 8 – 30 days.

During this period, visual acuity becomes unstable when the lighting changes. If the patient needs to read, watch TV or work on a computer, he must wear glasses.

Starting from the second week after surgery to replace the eye lens for cataracts, a person uses drops according to a scheme developed by specialists. Typically, these are solutions with anti-inflammatory and disinfectant effects. The dosage of these drugs should be gradually reduced.

Third phase: 31 – 180 days.

The final stage lasts longer than the previous ones, and throughout the entire time the patient will have to follow the prescribed regimen. If cataract surgery with lens replacement was performed with a laser or ultrasound, then at this stage the person can already see fully. But if the need arises, you can wear glasses or contacts.

After extracapsular or intracapsular cataract extraction, vision is restored only at the end of the third phase, after the final removal of the suture.

Possible complications

As with any surgical intervention, complications may occur after cataract removal. Such unpleasant consequences are explained by the individual characteristics of a particular organism, non-compliance with medical recommendations, or a doctor’s mistake during the operation.

Experts identify several main types of complications that occur most often:

Secondary cataract (15 – 40%). The problem develops after the patient has undergone extracapsular cataract extraction, ultrasound or laser phacoemulsification. The risk of such a complication is reduced if doctors used the latest technologies in microsurgery. In addition, the material from which the intraocular lens is made is very important. The complication is eliminated by surgical or laser capsulotomy.
Increased intraocular pressure (1-4%). This symptom is observed when the eyeball is damaged, due to the patient’s hereditary predisposition or due to excessive strain on the eyes.
Retinal detachment (0.3 – 5.6%). The nature of the damage is determined by how limited the field of vision is. Most often, the problem occurs in patients with diabetes or myopia. In order to correct the situation, another operation will be required.
Macular edema (1 – 6%). The macular area may swell after extracapsular extraction. The risk of such a complication after cataract removal increases the presence of diabetes and glaucoma.
Displacement of the iola (1 – 1.4%). The artificial lens may become dislodged after unskilled actions by the ophthalmologist. Even with a slight displacement, the patient urgently needs to be operated on again.
Hemorrhage in the anterior chamber of the eye (0.6 – 1.5%). This could be due to improper installation of the lens or heavy loads in the postoperative period. The problem is treated either with medication or repeated surgical intervention.
Iris loss (0.5 -1%). If specialists performed an operation with a small incision, then such a complication may occur. The problem manifests itself as uneven scarring of the wound, astigmatism, swelling and skin ingrowth. The treatment regimen for the complication depends on the time at which it appeared: if the iris falls out 2 weeks after the operation and the wound is not infected, the doctor will simply apply additional stitches. And if the intervention was carried out a long time ago, then the prolapsed iris is excised.

Immediately after surgery, a person may have pain in the eye, eyebrow, or temple. There is no need to be afraid of this, because this is a normal reaction of the body to eye injury. But to eliminate the risk of complications after replacing the lens of the eye, it is worth telling your doctor about the problem that has arisen. Only strict adherence to the doctor's instructions and the use of eye drops will help prevent the unpleasant consequences of surgery.

Therapeutic actions aimed at relieving the patient of complications must be carried out taking into account the cause of the development of the pathology and the degree of its neglect. Some complications resolve on their own and require only minor correction, while others require surgical intervention.

Major postoperative restrictions

Cataract removal with lens replacement is called a complex operation, although the rehabilitation period does not last for a long time. Due to the fact that the eye is injured, you need to try to do everything possible to heal it as quickly as possible. Here are a few restrictions that every patient undergoing surgery must adhere to:

Reducing eye strain. Throughout the entire rehabilitation period, a person who has had an artificial lens inserted should avoid visual strain.
Maintaining a sleep schedule. This includes the correct sleeping position: doctors do not recommend sleeping on your stomach or on the side where the problem eye is located.
In addition, you need to sleep at least 9 hours a day. This is the only way to achieve complete restoration of vision.
Proper hygiene. Replacing the lens of the eye requires that certain conditions be met when washing: you cannot use soap, gel or facial cosmetics. It is better to simply wipe your face with wet wipes and rinse your eyes with furatsilin or chloramphenicol.
Moderate physical activity. It is worth considering that excessive load can lead to increased intraocular pressure, lens displacement or hemorrhage. It is forbidden to move suddenly for a month after surgery.
Some sports will have to be forgotten forever: cycling, ski jumping and horse riding are not encouraged. In addition, you cannot do active exercises.
Heavy lifting should be limited. For the first 30 days, a person can lift no more than 3 kilograms.
For a month, you should not go to the bathhouse, sauna, sunbathe, or wash your hair with too hot water. If these restrictions are ignored, sudden bleeding may occur.
Use of cosmetics. Decorative cosmetics applied to the face a few days after surgery can cause unpleasant complications. The use of cosmetics is allowed only after 5 weeks, when vision is almost restored.
Restriction in nutrition and fluid. After lens replacement surgery, you should not consume a lot of salt, spices and animal fats. To avoid swelling, you should drink less water and tea.
You will have to give up alcohol and smoking for a long time. You can’t even be in the same room with smokers for at least a month.
Watching TV and sitting at the computer is allowed already on the 3rd day of the postoperative period. The only condition is to strain your eyes for no longer than 30 minutes.
To avoid complications after surgery, you should read in daylight. If you feel discomfort from the eyes, then the activity should be stopped immediately and resumed after some time.
Experts allow you to drive a car only 1 – 1.5 months after the lens of the eye has been replaced.
Be careful not to get any infection or foreign body into your eyes. If this happens, you should carefully rinse the eye or seek help from a doctor.
Temporarily avoid contact with pesticides and toxic substances. If the work requires this, then it is imperative to follow safety rules and use protective suits and personal protective equipment.

In order to monitor the process of restoring your health, you should regularly visit your doctor, who will prescribe the use of eye drops. Either the patient or the physician can choose which drops to give preference. It all depends on the person’s tolerance and allergies. For the first month, visits to the doctor should be made every week, in problematic cases - every day. Subsequent consultations should take place according to the previously drawn up schedule. As recovery from surgery progresses, restrictions may either be lifted or extended. In some cases, there may be significantly more of them, because the consequences of the operation cannot be predicted.

An artificial lens, replacing a natural one, helps a person see normally and avoid complete blindness. To ensure that cataracts do not cause complications and that rehabilitation occurs as quickly as possible, you need to choose a qualified ophthalmologist and strictly adhere to all his recommendations.

How to prevent cataracts?

To date, doctors have not established the exact factors that provoke the onset of the disease. Heredity and old age can be called the most common reasons for the development of cataracts. A person cannot have any influence on these parameters. But there are some things you can avoid and protect your vision:

Exposure of the eyes to ultraviolet radiation. Sunlight is a factor that negatively affects visual abilities. This is explained by the fact that the spectrum of light from the sun is somewhat wider than the spectrum of incandescent lamps that people use every day. While tanning is good for the skin, it is dangerous for the eyes, because vision cannot be restored on its own, so you should wear sunglasses.
People suffering from diabetes should think about cataract prevention at a young age. It is very important for such patients to achieve compensation for carbohydrate metabolism. It is this process that significantly reduces the risk of lens clouding.
In order to avoid cataracts caused by eye injury, you do not need to engage in extreme sports, during which you can fall and hit your head.
Detecting changes in vision at an early stage and diagnosing cataracts is only possible if a person regularly visits an ophthalmologist and closely monitors his health. If people know that they have vision problems and wear glasses or contact lenses all the time, then experts recommend that they purchase special glasses with a photochromic lens, called “chameleons.” Their peculiarity is that indoors and outdoors they change their properties: they become light in the room, and darken in the sun.

After cataract surgery is performed, the eyes gradually recover and vision improves. But one operation is not enough: following the basic rules that apply to the postoperative period will help maintain visual acuity and speed up the rehabilitation process.