Swelling after lens replacement. Rehabilitation after cataract removal

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

Cataract treatment

Complications of cataract surgery

Cataract extraction operation. 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 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,
rise in intraocular pressure,
displacement (decentration, dislocation) of the artificial lens,
retinal disinsertion.

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

With 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 picture of the fundus becomes clear).

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

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

With an increase in intraocular pressure, drops are prescribed, the treatment of which is usually effective. In rare cases, an additional operation is required - a puncture (puncture) of the anterior chamber and its washing.

Violation of the correct position of the optical part of the artificial lens can adversely 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 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 exertion, double vision often appears when looking into the distance, and there may be complaints of discomfort in the eye. Complaints are usually not permanent and disappear after rest. With a significant displacement of the IOL (0.7-1 mm), patients feel constant visual discomfort, there is doubling, mainly when looking into the distance. The sparing mode of visual work does not give effect. With the development of such complaints, repeated surgical intervention is required. consisting in correcting the position of the IOL.

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

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

Late postoperative complications:

Secondary cataract. The capsular bag contains an artificial lens. Numerous Elschnig balls on the posterior capsule.

"Window" in the posterior lens capsule after YAG laser capsulotomy

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

Edema of the macular area of the retina is one of the complications in 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 within 4 to 12 weeks after surgery.

The risk of developing macular edema increases with a past eye injury. 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 a secondary cataract is as follows: the cells of the lens epithelium that were not removed during the operation are converted into lens fibers (as it happens during the growth of the lens). However, these fibers are functionally and structurally defective, irregular in shape, not transparent (the so-called Adamyuk-Elschnig ball cells). When they migrate from the growth zone (the equator region) to the central optical zone, an opacity is formed, a film that reduces (sometimes very 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, the choice of IOLs of special designs, and much more.

Secondary cataract can form within a few months to several years after surgery. Treatment consists of a posterior capsulotomy - creating an opening in the posterior lens capsule. Carrying out this manipulation frees the central optical zone from opacities. allows light rays to freely enter the eye. significantly improves visual acuity.

Capsulotomy can be performed by mechanically removing the film with a surgical instrument. or with a laser. The latter method is preferable, since it is not accompanied by the introduction of an instrument into the eye.

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

Like surgery. and laser capsulotomy - manipulation. performed on an outpatient basis. Removal of a secondary cataract is a procedure that allows a patient to restore high visual acuity in a few minutes, provided that the neuro-receptor apparatus of the retina and optic nerve is preserved.

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 lens of the eye. Like everything in our body, the eye lens is also subject to the normal aging process, which also leads to the fact that it becomes cloudy during life. This happens at a different pace for each person, and certain medications, as well as smoking or eye trauma, can hasten the process of clouding the lens and, therefore, the onset of cataracts. Most often, this disease is due to age, so 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 perceived at first as a thin veil in front of the eyes, which becomes more and more dense over time. Often people with cataracts become more sensitive to light. Sometimes their visual acuity improves for a short time because the refraction of the eye can 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 is noticeably worsened as a result, cataract surgery is the only treatment option.

Cataract

cataract video

Clouding of the lens, 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, an important part of the refractive apparatus of the eye, focusing light as it travels to the back of the eye.

Until the age of 45, the shape of the lens of a person's eye can 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 blurred. This condition is known as a cataract.

Causes of cataract

Eye surgery

Too much exposure to ultraviolet (sunlight)

In many cases, the causes of cataracts are unknown, but sometimes children are born with it, this is the so-called congenital cataract.

Symptoms of a cataract

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

Visual issues may include the following changes:

Sensitivity to bright light

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

Problems with the perception of shape or difference 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 not see as well as the other. Many people with this condition have only minor visual changes.

Cataract: complications. Cataract complications

Recovery after cataract surgery is uneventful in 98% of patients. Complications, moderate or severe, are 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 fact that the patient loses not only sight, but also the eye itself. Reducing the risk to a minimum is possible with the use of 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 surgery may be required.

Increase the likelihood of intraocular infection discharge from the incision. In some cases, additional sutures are needed, 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 ailment 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 incision or puncture does not affect the blood vessels. However, a bleeding vascular membrane of the eye can cause vision loss, so this complication should be taken very seriously.

Cataract removal is dangerous and the likelihood of an increase in intraocular pressure is secondary glaucoma. This disease is treated with medication, but in some individual cases, surgery is required.

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

Some complications may occur even a year after the operation. This is a 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 fast and painless. Incomplete removal of the lens masses during cataract surgery will 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 a cataract, complications can occur not only after surgery, but also in the process of maturation of the disease. And the cataract itself can become a complication of other diseases, for example, diabetes.

Do not underestimate the disease. Even an immature cataract can cause irreparable damage to vision. To avoid premature development of the disease, you need to carry out regular prophylaxis and periodically visit an ophthalmologist. And in no case should you refuse treatment, even a complicated cataract, when the lens is removed and replaced with an artificial lens, will not be able to 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 experienced 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 vast experience of the doctor, there is still a possibility that visual impairment will occur after phacoemulsification. Therefore, all patients, before going to the operation, want to know what complications can be after cataract surgery and how it can be corrected.

What are the types of complications after cataract removal?

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

Postoperative issues include:

implant displacement;
inflammatory reactions;
retinal disinsertion;
increase in eye pressure (about the norm of IOP );
hemorrhage in the anterior chamber of the eye;
secondary cataract.

These complications appear in 1.5%. And 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 after a surgical procedure feel discomfort and do not dare to tell the doctor about it during the examination. Because of this, problems arise that can cause significant damage to vision.

What vision problems can occur over time?

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

Even after phacoemulsification, vision problems can occur. The risk of getting them is very small. You should never be silent about the discomfort you experience. After all, experienced professionals will help eliminate it. And then there will be no

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 environmental information.

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

Disease Definition

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, such as dust particles floating in the air. With high sensitivity, the cornea saves the eye from clogging by closing the eyelashes, as well as washing out particles with tear fluid. With the development of the lesion, its properties change, light transmission decreases, photophobia develops, vision is significantly reduced, 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 corneal layer substance, and then to its necrosis.

Causes

Causes of corneal edema can be as follows:

Symptoms

Corneal edema is manifested 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. This changes the structure of the main part of the cornea - the stroma; , there is a penetration of lipids and a violation of the transparency of the cornea.

Corneal edema may be accompanied by symptoms such as:

Often, corneal edema is asymptomatic, and this pathology can only be detected when examining an ophthalmologist.

Possible Complications

If the edema is neglected and chronic, vascularization occurs, i.e. new blood vessels form inside the cornea. This sign can be seen only during biomicroscopic examination.

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

Treatment

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

in a medical way

The tactics of treatment with medications is selected depending on the cause that provoked the edema of the cornea.

The reason is contact lenses.

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

A bacterial infection is often the result of improper lens wear. Bacteria such as Staphylococcus aureus, Pseudomonas aeruginosa, amoebic infection provoke corneal edema.

Treatment in this case is the local application of antibacterial agents., such as , . The antibiotics contained in these preparations will quickly and effectively help the patient.

Levofloxacin is used for corneal edema

The reason is a complication after cataract surgery

Corneal edema after cataract surgery sometimes occurs the next day after the procedure. The cause of the edema in this case is a large amount of fluid that passes through the eye during crushing and washing out of the replaced lens of the eye. The denser the cataract and the lower the vision, the more likely the development of 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, edema is removed with the help of injections and procedures, which, if necessary, are prescribed by the attending physician.

infections

Treatment of infectious diseases that caused corneal edema requires antifungal or. Usually, local remedies (eye drops) are used, but in more severe conditions, tablets or intravenous injections are prescribed.

For viral diseases use preparations containing interferon (for example,), as well as artificial tears.

Ophthalmoferon is used for viral diseases of the cornea of the eye

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

Moxifloxacin is used for bacterial infections

Allergic reaction

To remove allergic corneal edema, the first step is to identify and eliminate contact with the allergen (cosmetics, dust, animal dander, plant 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.. Minor injury does not require treatment. If the damage is significant, then the doctor should be called immediately. Before help arrives, blink frequently (if the foreign body does not interfere with this) and rinse the eye with clean water.

In case of injury, do not rub your eyelids with your fingers, do not independently pull out a foreign body that has stuck into the eye.

Surgically

If conservative treatment methods do not help, then the doctor may recommend surgery. In case of violations in the cornea, it is transplanted, and in some modern clinics, the cornea is sealed with ultraviolet light.

Folk remedies

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

Prevention

Preventive measures against corneal edema:

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

An important role in the prevention of pathological conditions of the cornea is played by the correct selection of contact optics. Lenses must be of high quality, allowing oxygen to pass to the eyes. Lenses must be used correctly.

Choose cosmetics for the eyelids and eyelashes in terms of health safety, it should not contain allergens that cause swelling.

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

Work should be selected one that does not require strong physical activity, inclinations. During sleep, it is necessary to lie down so that the head is higher than the legs, which will ensure the necessary outflow of blood.

It is forbidden to swim, go to the sauna after the treatment of edema.

If these rules are observed, re-edema of the cornea of the eye can be avoided.

Video

conclusions

Most often, corneal edema is, which has a different origin. It is very important to establish the cause of the state of swelling with the help of medical diagnosis, after which it is possible to carry out treatment aimed at effectively eliminating the cause of the disease.

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Classmates

A cataract is a 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 had an eye injury, have diabetes, and can also be a consequence of radiation therapy.

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

Complications after cataract removal are divided into 2 types:

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

inflammatory reactions. These include uveitis (inflammation of the vascular eye) and iridocyclitis (inflammation of the iris and ciliary body of the eye). Such a reaction is a completely normal response of the body to an injury that occurred during the course of the operation. If the postoperative period proceeds without complications, then the inflammatory process will pass by itself in a couple of days and the eye will return to its original state.
rise in intraocular pressure. Associated with clogging of the 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 disinsertion. Most often observed with myopia or surgical injuries, it is treated with repeated intervention.
displacement of the artificial lens. Misalignment in the capsular bag or incompatibility of the bag with the lens leads to displacement. Corrected by repeated surgery.

Late complications after cataract removal are:

secondary cataract. A frequently observed late complication arising after surgery. It arises due to the fact that not completely removed epithelial cells continue their development further, transforming into lens fibers. After they move to the central optical zone, turbidity occurs, which reduces vision. It is treated with simple surgery or with a laser.
swelling of the macular area of the retina. The second name is the Irwin-Gass syndrome. It is an accumulation of fluid in the macula of the eye (macula), leading to a decrease in 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 going smoothly. Moderate to severe complications are extremely rare but require immediate medical attention.

Eye infections after cataract surgery are very rare - one case in several thousand. But if the infection develops inside the eye, you can lose your sight 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 medical treatment. However, an infection can develop in the eye very quickly, even within a day after surgery, in which case immediate treatment is required.

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

Small discharges from an incision in the cornea are rare, but can create a high risk of intraocular infection and other unpleasant consequences. If this happens, your doctor may recommend a contact lens or apply pressure to the eye to promote healing. But sometimes additional sutures are applied to the wound.

Some people may develop pronounced astigmatism after surgery due to inflammation of the tissues or too tight sutures - an incorrect curvature of the cornea, which causes blurred vision. But when the eye heals after surgery, the swelling goes down, and the stitches are removed, the astigmatism usually gets better. 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 choroid, a thin membrane in the middle layer of the eye between the sclera and the retina, is a rare but serious complication that can cause complete loss of vision.

Another possible complication after cataract surgery is secondary glaucoma, an increase in intraocular pressure. It is usually temporary and may be caused by inflammation, bleeding, adhesions, or other factors that increase intraocular (in the eyeball) pressure. Medical treatment of glaucoma usually helps control blood pressure, but sometimes laser treatment or surgery is required. Retinal detachment is a serious condition in which the retina separates from the back of the eye. Although this does not happen often, it requires surgical intervention.

Sometimes 1-3 months after cataract surgery, the macular tissue of the retina becomes inflamed. This condition is called cystoid macular edema. characterized by blurred central vision. With the help of a special analysis, an ophthalmologist can make a diagnosis and carry out drug treatment. In rare cases, the implant may move. In this case, blurred vision, bright "double" vision, or intermittent vision are possible. If this interferes with normal vision, the ophthalmologist may replace the implant or replace it.

In 30-50% of all cases, the residual shell (the capsule left in the eye to support the implant) becomes cloudy some time after surgery, causing blurry vision. It is often called secondary, or post-cataract, but this does not mean at all that the cataract has formed again; it is only 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 shell to allow light to pass through. This can be done quickly and painlessly, without incisions.

Complications After Cataract Surgery

Types of complications

rise in intraocular pressure;
uevitis, iridocyclitis - inflammatory eye reactions;
retinal disinsertion;
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 in clouding of the posterior capsule. It was found 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 already 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, have not yet been fully studied.

It is generally accepted that this complication is due to the migration of the lens epithelium into the space between the lens and the posterior capsule. The epithelium of the lens is the cells left after its removal, which contribute to the formation of deposits that significantly impair image quality. Another possible cause is fibrosis of the lens capsule. The elimination of such a defect is carried out using a YAG laser, which forms 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 leaching of viscoelastic, a gel-like special preparation that is injected into the anterior chamber to protect the structures of the eye from surgical damage. In addition, the development of a pupillary block may be the cause if the IOL has shifted to the iris. The elimination of this complication does not take much time, in most cases it is enough to drip antiglaucoma drops for several days.

Cystoid macular edema (Irvine-Gass syndrome)

A similar complication occurs after cataract phacoemulsification in about 1% of cases. While the extracapsular lens removal technique makes it possible to develop 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 also increases after cataract extraction, which is complicated by rupture of the posterior capsule or loss of the vitreous body. Treatment is carried out with the help of corticosteroids, NSAIDs, angiogenesis inhibitors. With the ineffectiveness of conservative treatment, vitreectomy can sometimes be prescribed.

A fairly common complication of cataract removal. Causes - a change in the pumping function of the endothelium, which occurred due to mechanical or chemical damage during the operation, an inflammatory reaction, or concomitant ocular pathology. As a rule, the edema disappears in a few days, without the appointment of treatment. In 0.1% of cases, pseudophakic bullous keratopathy may develop, accompanied by the formation of bulls (vesicles) in the cornea. In such cases, hypertonic solutions or ointments are prescribed, therapeutic contact lenses are used, and the pathology that caused this condition is treated. The lack of effect of treatment may lead to the appointment of corneal transplantation.

A very common complication of IOL implantation, leading to a deterioration in the result of the operation. At the same time, the magnitude of induced astigmatism is directly related to the method of cataract extraction, the length of the incision, its localization, 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 with the help of contact lenses; with severe astigmatism, refractive surgery is possible.

Displacement (dislocation) of the IOL

A fairly rare complication compared to the above. Retrospective studies have revealed 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 Zinn ligaments 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 the operation, those who injured the eye in the period after surgery, those with myopic refraction, and diabetics are at risk. In 50% of cases, such a detachment occurs in the first year after surgery. Most often, it occurs after intracapsular cataract extraction (in 5.7% of cases), least often after extracapsular cataract extraction (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 up by an ophthalmologist in order to detect this complication as early as possible. The principle of treatment of this complication is the same as for detachments of a different etiology.

Very rarely, during cataract surgery, choroidal (expulsive) bleeding occurs - an acute condition that is absolutely impossible to predict in advance. With it, bleeding develops from the affected vessels of the choroid, which lie under the retina, nourishing it. Risk factors for the development of such conditions are arterial hypertension, a sudden rise 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 little or no effect on visual functions, but sometimes its consequences can even lead to 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 rather 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 with the patient's blepharitis, conjunctivitis, canaliculitis, obstruction of the nasolacrimal ducts, entropion, when using contact lenses, a prosthetic fellow eye, after immunosuppressive therapy. Signs of an intraocular infection can be: severe redness of the eye, increased photosensitivity, pain, decreased vision. Prevention of endophthalmitis - instillation of 5% povidone-iodine before surgery, introduction of antibacterial agents into the chamber or subconjunctivally, sanitation of possible foci of infection. Especially important is the use of disposable or thorough disinfection of reusable surgical instruments.

Benefits of treatment at MHC

Almost all of the above complications of surgical treatment of cataracts are poorly predictable and are often associated with circumstances beyond the skill of the surgeon. 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.

Using the services of the specialists of 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. We offer our patients the latest diagnostic and surgical equipment, the best ophthalmologists and ophthalmic surgeons in Moscow, attentive medical staff. The specialists of the clinic have accumulated sufficient experience in the effective treatment of complications of cataract surgery. The clinic has a comfortable round-the-clock 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 a pupillary block, or clogging of the drainage system with special viscous preparations - highly elastic, used at all stages of the operation to protect the intraocular structures and, especially, the cornea of the eye, if they are not completely washed out of the eye .In this case, when intraocular pressure rises, instillation of drops is prescribed, and this is usually enough. Exceptionally in rare cases, with an increase in intraocular pressure in the early postoperative period, an additional operation is performed - a 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 the extensive experience of a specialist does not exclude the development of complications after cataract surgery, because. Any surgical intervention carries a certain degree of risk.

Types of pathologies after surgery

Doctors after surgery divide the negative results of the operation into two components:

Intraoperative - occur during the work of surgeons.
Postoperative - develop after surgery, depending on the time of their occurrence, they 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 the tissues of the eye to an intervention. At the final stages of the operation, doctors administer anti-inflammatory drugs (antibiotics and steroids), which have a wide spectrum of action.

Intraocular bleeding after cataract surgery occurs in rare cases. The 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 will cauterize this area, stopping it.

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

Such a complication after cataract surgery as dislocation of the lens is less common. Studies show that the risk of this phenomenon in patients 5, 10, 15, 20 and 25 years after surgical treatment is low. Patients with a pronounced degree of myopia are at high risk of getting retinal detachment in the surgical department.

Complications of a postoperative nature

Edema 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 material of the lens. For polyacryl, it is approximately 10%. For silicone - 40%. For PMMA material - more than 50%.

Secondary cataract as a complication after surgery may not occur immediately, after several months after the intervention. The treatment in this case is to perform a capsulotomy - this is the creation of an opening in the lens capsule located behind. 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 visual acuity.

Puffiness, characteristic of the macular zone of the retina, is also a pathology that is typical during operations in the front of the eye. This complication can occur within 3 to 13 weeks after the end of the operation.

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 edema after surgery in people suffering from glaucoma, high blood sugar and inflammatory processes occurring in the choroid.

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

Cataract belongs to the category of ophthalmic 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 most common eye diseases is cataract. It most often occurs in older people.

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

Surgical removal of a cataract is a highly effective, but rather complex and jewelry 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 be the result of a medical error.

Common complications are described below.

Watery eye

Excessive lacrimation may be the result of infection. Infection in the eye during the operation is practically excluded due to the observance of sterility. However, non-compliance with the recommendations of the doctor in the postoperative period (washing with running water, constant rubbing of the eye, etc.) can lead to infection. In this case, antibacterial drugs are used.

Eye redness

Redness of the eye can be both a sign of infection and a symptom of a more formidable complication - hemorrhage. Hemorrhage into the eye cavity can occur during traumatic cataract surgery and requires immediate specialist attention.

Corneal edema

The consequences of cataract surgery may include swelling of the cornea. A mild degree of swelling is quite common and most often manifests itself 2-3 hours after the operation. Most often, mild swelling resolves on its own, however, in order to speed up the process, the doctor may prescribe eye drops. During the period of swelling, vision may be blurry.

Pain in the eye

In some cases, intraocular pressure increases after cataract removal. Most often this occurs due to the use of a solution during the operation, which cannot normally pass through the drainage system of the eye. An increase in pressure is manifested by pain in the eye or headache. As a rule, increased intraocular pressure is stopped by medication.

Retinal disinsertion

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

A rather 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, by darkening in the eyes. The most striking manifestation is “double vision” in the eyes. With a 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 holding it. In the case of prolonged displacement (more than 3 months), the lens may heal, which subsequently complicates its removal.

Endophthalmitis

A rather serious complication of cataract surgery is endophthalmitis - an extensive inflammation of the tissues of the eyeball. Launched endophthalmitis can cause loss of vision, so it is impossible to postpone its treatment in any case. The average incidence of endophthalmitis after cataract removal is about 0.1%. Patients with thyroid diseases and weakened immune systems are at risk.

Opacification of the lens capsule

Among the complications after cataract removal is clouding of the posterior lens capsule. The reason for the development of this complication is the "growth" of epithelial cells on the posterior capsule. This complication can lead to a deterioration in vision and a decrease in its acuity. Opacification of the posterior capsule occurs quite often - in 20-25% of patients undergoing cataract removal. The treatment of 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, after which it is recommended to instill anti-inflammatory drops. The patient after laser therapy can immediately return to the normal rhythm of life. Sometimes after the procedure, blurred vision is noted, which quickly disappear.

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

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

rise in intraocular pressure; uevitis, iridocyclitis - inflammatory eye 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, after about 2-3 days, the symptoms of the response completely disappear.

Hemorrhage into the anterior chamber

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

Rise in intraocular pressure

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

Retinal detachment

Such a complication is considered severe, and it occurs in case of eye injury after surgery. In addition, retinal detachment is most common in people with myopia. In this case, ophthalmologists most often decide on an operation, which consists in sealing the sclera - vitrectomy. In the case of a small area of detachment, restrictive laser coagulation of the rupture of the eye retina can be performed. Among other things, retinal detachment leads to another problem, namely lens displacement. Patients at the same time begin to complain of rapid eye fatigue, pain, as well as double vision that appears when looking into the distance. The symptoms are intermittent and usually disappear after a short rest. When there is a significant displacement (1 mm or more), the patient feels constant visual discomfort. This problem requires re-intervention.

Full lens shift

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

Secondary cataract

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

Rupture of the posterior capsule

This is a rather serious complication, as it may be accompanied by loss of the vitreous body, migration of the lens masses posteriorly, and less often, expulsive bleeding. With inappropriate treatment, long-term effects of vitreous loss include a retracted pupil, uveitis, vitreous opacities, wick syndrome, secondary glaucoma, posterior dislocation of the artificial lens, retinal detachment, and chronic cystic macular edema.

Signs of posterior capsule rupture

Sudden deepening of the anterior chamber and sudden dilation of the pupil. The failure of the core, the impossibility of pulling it to the tip of the probe. Possibility of vitreous aspiration. A ruptured capsule or vitreous body is clearly visible.

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

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

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

With a small rupture of the posterior capsule, careful implantation of the SC-IOL into the capsular bag is possible.

With a large gap, and especially with intact anterior capsulorhexis, it is possible to fix the SC-IOL in the ciliary sulcus with the placement of the optical part in the capsular bag.

Insufficient capsule support may necessitate sulcular suturing of the IOL or implantation of a PC-IOL using a glide. However, PC-IOLs cause more complications, including bullous keratopathy, hyphema, iris folds, and pupillary irregularity.

Dislocation of lens fragments

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

NB: There may be cases where it is impossible to achieve the correct position even for the PC-IOL. Then it is more reliable to refuse implantation and decide on the correction of 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 functions. Others recommend postponing surgery for 2-3 weeks and treating uveitis and elevated intraocular pressure. Hydration and softening of the lens masses during the treatment facilitates their removal with a vitreotome.

The surgical technique includes pars plana vitrectomy and removal of soft fragments with a vitreotomy. More dense fragments of the nucleus are connected by the introduction of viscous fluids (for example, perfluorocarbon) and further emulsification with a phragmatome in the center of the vitreous cavity or by 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 SC-IOL into the vitreous cavity

Dislocation of the SC-IOL into the vitreous cavity is a rare and complex phenomenon, indicating improper implantation. Leaving the IOL can lead to vitreal hemorrhage, retinal detachment, uveitis, and chronic cystic 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 its replacement with a PC-IOL, scleral fixation of the same intraocular lens with a non-absorbable suture, implantation of an iris clip lens.

Hemorrhage into the suprachoroidal space

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

Signs of suprachoroidal hemorrhage

Increasing grinding of the anterior chamber, increased intraocular pressure, iris prolapse. Leakage of the vitreous body, the 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 out through the incision area.

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

ultrasound is used to assess the severity of the changes that have occurred; the operation is indicated 7-14 days after the liquefaction of blood clots. Blood is drained, vitrectomy is performed with air/fluid exchange. Despite an unfavorable prognosis for vision, residual vision may be preserved in some cases.

Edema is usually reversible and is most often caused by the operation itself and trauma to the endothelium in contact with instruments and the intraocular lens. Patients with Fuchs endothelial dystrophy present 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 may occur with EEC.

Causes of iris prolapse

The incision during phacoemulsification is closer to the periphery. Moisture seepage through the incision. Poor suturing after EEK. Patient-related factors (cough or other tension).

Iris prolapse symptoms

On the surface of the eyeball in the area of the incision, the fallen out tissue of the iris is determined. The anterior chamber in the incision area may be shallow.

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

Treatment depends on the interval between surgery and the detection of prolapse. If the iris falls out during 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 disorders of the structures of the eye. When the edge of the intraocular lens is shifted into the pupil area, patients are disturbed by visual aberrations, glare and monocular diplopia.

The displacement of the intraocular lens mainly occurs during surgery. It can be due to dialysis of the zonium ligament, rupture of the capsule, and can also occur after conventional phacoemulsification, when one haptic part is placed in the capsular bag, and the second in the ciliary sulcus. Postoperative causes are trauma, irritation of the eyeball and shrinkage of the capsule.

Treatment with miotics is beneficial with little displacement. Significant displacement of the intraocular lens may require its replacement.

Rheumatogenous retinal detachment

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

"Retinal" retinal degeneration or tears require prior treatment before cataract extraction or laser capsulotomy if ophthalmoscopy is possible (or as soon as it becomes possible). High myopia.

During the operation

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

Carrying out YAG-laser capsulotomy in the early stages (within a year after the operation).

Cystic retinal edema

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

In contact with

With the appearance and progression of cataracts, doctors advise to immediately perform an operation, during which the lens will be replaced. Older people or people with any chronic diseases may face a similar problem. If you do not seek qualified help in a timely manner, then there is a risk of losing your sight forever.

The operation to replace the lens of the eye requires compliance with certain conditions during the rehabilitation period, which can take several months. This article talks about how to behave at this time and what non-compliance with the established rules can lead to.

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The essence of the operation

Each operation is a technically complex surgical intervention. If we are talking about lens replacement, then the patient will need phacoemulsification, a high-tech sutureless surgery technique 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 for an elderly person whose vision has become blurry and fuzzy. In addition, the patient may develop and progress farsightedness or nearsightedness.

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

Through a self-sealing incision, physicians use a laser to turn the damaged lens into an emulsion.
The remains of the lens are removed by suction.
An elastic artificial lens is placed in the eyeball, which independently straightens on the eye.
The procedure is performed under local anesthesia in a hospital setting. It lasts no longer than an hour, depending on how severely the cataract is started and how densely the lens is clouded.

The operation has many advantages. Here are some of them:

Well tolerated at any age.
Does not cause pain to the patient.
Does not require any serious restrictions in the rehabilitation period.
Leaves no seams.
It implies the use of safe materials and high quality tools.

All these advantages over outdated methods allow you to perform an operation called phacoemulsification in the shortest possible time with a minimum of complications.

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

Inflammatory process before the eyes.
Too small anterior chamber of the eyeball.
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 and on the qualifications of the attending physician.

After phacoemulsification has been performed - an operation to replace the lens in cataracts - a person should be under the supervision of the attending physician for some time. The process is carried out 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 follow-up visit to a specialist should be carried out a day after the operation. Further, such examinations are carried out daily for about two weeks.

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

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 excludes blinking. In the case when the healing process is active, goggles can be used instead of a bandage.

The incision on the eyes finally heals after 7 days. During this week, a person should not wash his hair and take a shower. In addition, it is forbidden to drink alcohol and carbonated drinks. After the 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 notice an immediate improvement in vision after lens replacement surgery, the eyes are fully 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 prescriptions, then you can not be afraid of possible complications and very soon return to preoperative life.

Clouding of the lens - symptoms and treatment of the disease

rehabilitation period

The duration of rehabilitation directly depends on the type of intervention performed. The fastest people who have undergone ultrasonic or laser phacoemulsification come back to normal.

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

First phase: 1 - 7 days after surgery.

This stage is characterized by pains of a different nature both in the eye itself and around it. This symptom is successfully stopped 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 eyelid swelling. This phenomenon does not require medication, but is removed by limiting drinking, correct posture during sleep and reviewing the diet.

Second phase: 8 - 30 days.

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

Starting from the second week after the operation to replace the lens of the eye with cataracts, a person uses drops according to the scheme developed by specialists. Usually, these are solutions with anti-inflammatory and disinfectant action. 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 comply with the prescribed regimen. In the event that the operation to remove the cataract with the replacement of the lens was carried out with a laser or ultrasound, then at this stage the person already fully sees. But if necessary, you can wear glasses or lenses.

After extracapsular or intracapsular cataract extraction, vision is restored only by 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 the recommendations of doctors, 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, ultrasonic or laser phacoemulsification. The risk of such a complication is reduced if the doctors used the latest technologies in microsurgery. In addition, the material from which the iol is made is very important - an intraocular lens. 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 eye strain.
Retinal detachment (0.3 - 5.6%). The nature of the damage is determined by how limited the field of view. Most often, the problem occurs in patients with diabetes or myopia. In order to correct the situation, another operation is required.
Macular puffiness (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 iol (1 - 1.4%). The artificial lens can be displaced after unskilled actions of the optometrist. Even with a slight displacement of the patient, it is urgent to operate again.
Hemorrhage in the anterior chamber of the eye (0.6 - 1.5%). Here, the fault may be the incorrect installation of the lens or heavy loads in the postoperative period. The problem is treated either with medication or with repeated surgical intervention.
Prolapse of the iris (0.5 -1%). If the specialists performed the operation with a small incision, then such a complication may occur. The problem is manifested by uneven scarring of the wound, astigmatism, swelling and ingrowth of the skin. The treatment regimen for the complication depends on how long it manifested itself: if the iris fell out 2 weeks after the operation and the wound is not infected, then the doctor will simply put additional stitches. And if the intervention was carried out a long time ago, then the fallen iris is excised.

Immediately after surgery, a person may have pain in the eye, brow, or temple. There is no need to be afraid of this, because this is a normal reaction of the body to an eye injury. But in order 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 prescriptions and the use of eye drops will help prevent the unpleasant consequences of surgery.

Therapeutic actions aimed at ridding the patient of complications should be carried out taking into account the cause of the development of the pathology and the degree of its neglect. Some complications go away 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 drag on for a long time. Due to the fact that the eye is injured, you need to try to do everything possible for its speedy healing. Here are a few restrictions that every patient who has undergone surgery should adhere to:

Reducing eye strain. Throughout the rehabilitation period, a person who has had an artificial lens inserted should avoid eye strain.
Sleep compliance. This includes the correct sleeping position: doctors do not recommend sleeping on the stomach and on the side where the problem eye is located.
In addition, sleep should be given at least 9 hours a day. Only in this way will it be possible to achieve complete restoration of vision.
Proper hygiene. Replacing the lens of the eye implies the fulfillment of certain conditions when washing: you can not 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 loading can lead to increased intraocular pressure, lens displacement or hemorrhage. It is forbidden to move sharply for a month after surgery.
Some sports will have to be forgotten forever: cycling, ski jumping into the water and equestrian sports are not welcome. In addition, you can not do active charging.
Weight lifting should be limited. The first 30 days a person can lift no more than 3 kilograms.
For a month, you can not go to the bath, sauna, sunbathe and wash your hair with too hot water. If these restrictions are ignored, sudden bleeding may develop.
Use of cosmetics. Decorative cosmetics applied to the face a few days after the operation can provoke unpleasant complications. It is allowed to use cosmetics only after 5 weeks, when vision is almost restored.
Restriction in food and fluids. After the lens replacement surgery, you should not eat a lot of salt, spices and animal fats. To avoid the appearance of puffiness, it is worth drinking less water and tea.
You will have to give up alcohol and smoking for a long time. At least a month you can not even be in the same room with smokers.
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 the operation, it should be read in daylight. If discomfort is felt from the eyes, then the lesson should be stopped immediately and resumed after some time.
Experts allow driving a car only after 1 - 1.5 months after the replacement of the lens of the eye was carried out.
Be careful not to get an infection or foreign body in your eyes. If this happens, then the eye should be gently rinsed or seek medical help.
Temporarily avoid contact with pesticides and toxic substances. If the job requires it, then it is imperative to follow safety rules and use protective suits and personal protective equipment.

In order to control the process of restoring health, you should regularly visit your doctor, who will prescribe the use of eye drops. Which drops to prefer can be chosen either by the patient himself or by the doctor. It all depends on tolerance and whether a person has allergies. The first month, visits to the doctor should be carried out every week, in problem cases - every day. Follow-up consultations should take place according to the previously established schedule. As rehabilitation progresses after surgery, the restrictions may be either lifted or extended. In some cases, they can become much larger, because the consequences of the operation cannot be predicted.

An artificial lens that replaces the natural lens helps a person to see normally and avoid total blindness. So that the cataract does not cause complications, and the rehabilitation takes place as quickly as possible, you need to choose a qualified ophthalmologist and strictly adhere to all his recommendations.

How to prevent the appearance of 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 causes for the development of cataracts. These parameters cannot be influenced in any way. But there are some points that you can avoid and protect your eyesight:

Eye exposure to ultraviolet radiation. Sunlight is the factor that negatively affects visual capabilities. This is due to the fact that the spectrum of light from the sun is somewhat wider than the spectrum of incandescent lamps that a person uses daily. If a tan is good for the skin, then it is dangerous for the eyes, because vision is not able to recover on its own, so you should wear sunglasses.
People suffering from diabetes should start thinking about cataract prevention at a young age. It is very important for such patients to achieve compensation of carbohydrate metabolism. It is this process that significantly reduces the risk of clouding of the lens.
In order to avoid cataracts caused by an eye injury, you do not need to engage in extreme sports, during which you can fall and hit your head.
Detecting a change in vision at an early stage and diagnosing a cataract is possible only if a person regularly visits an ophthalmologist and carefully monitors his health. If people are aware of the presence of vision problems and wear glasses or lenses constantly, then experts recommend that they purchase special glasses with a photochromic lens, called "chameleons". Their peculiarity lies in the fact that indoors and outdoors they change their properties: they become light in the room, and darken in the sun.

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