What not to do after eye surgery. Advanced age is not an obstacle to cataract treatment

When choosing a place where the operation will be performed, you should pay attention to how the medical institution is equipped, how qualified the doctors are, and be sure to find out about the reviews of those who have already had surgery here.

Types of surgical interventions

Among the types of surgical interventions to restore vision, the main ones can be identified as laser treatment, such as scleroplasty and vicrectomy. All operations have their own characteristics and caveats; the final decision always remains with a qualified surgeon.

• Laser treatment is used to remove the superficial layer of the cornea. For this, the LASIK method is used, as well as such a method as. In rare cases, intervention is resorted to when it increases significantly. Glaucoma may disappear only for a certain time, symptoms may recur, so other methods are required to treat more serious diseases.
• Scleroplasty aims to secure the upper layers of the eyeball, which allows. This method is also well established and is a simple intervention. It does not have any serious consequences; the patient is operated on under local anesthesia.
• Vitrectomy is a complex type of operation that is performed on an outpatient basis and takes a fairly long period, about three hours, in the absence of complications. During the process, the surgeon removes tissue affected by the disease, destructive fibers of the vitreous body, and in especially severe cases, the vitreous body is completely removed. As a replacement, a special liquid or silicone filling is used.

Laser correction

You need to lie down, since the procedure cannot be done while standing.

• The lower part of the eyelid should be slightly pulled back.
• Place two drops and release the eyelid.
• You can press a sterile napkin.
• When prescribing several drugs, maintain an interval of at least five minutes.
• Do not touch any part of the eye with the dropper.

If it was of a severe nature, the doctor may require wearing a bandage, this helps protect the eyes from various unpleasant moments in the form of natural phenomena, damage and other unforeseen moments. Here it is better to use disposable materials.

During the postoperative period, the eyes may turn red and become more watery, but these symptoms will disappear after a few days; you should be patient. In order to monitor the progress of recovery, dates are set for visiting the doctor, so The plan must be followed strictly:

• Inspection after manipulations.
• A week later.
• In a month and beyond. Here everyone can have an individual scheme.

Rules for patient behavior after cataract removal, it is forbidden:

• Sleep on the side of the operated eye.
• Make sudden movements.
• Lift weights.
• To drive a car.

Any intervention in internal organs can cause complications, the eyes are no exception, which is why it is so important to follow the doctor’s instructions. However, there are often cases of negative consequences, they may appear as:

• Hemorrhages.
• Infection.
• Swelling.
• Increased pressure inside the eye.
• Lens displacement.

There may be more complications, some of which are very severe, but every person has a chance for a successful recovery. In case of any inflammation or deviations from the norm during rehabilitation, all medical care falls on the shoulders of the clinic where the operation was performed.

Surgery to treat glaucoma

After it has been carried out, the patient is given advice to alleviate the condition, which includes the main points that help to achieve fast and effective healing.

• The patient must lie still on his back for several hours.
• Do not touch your eyes or use homemade eye washes other than those prescribed by your doctor. Any raw water that gets into the eye can cause inflammation or infection.
• To prevent dust from getting on the eye surface, you should wear sun and dust glasses.
• Any severity is harmful at this time and overexertion can cause increased pressure or rupture of blood vessels.

Laser basal as an effective method of treating glaucoma.

It is worth saying that all recommendations after eye surgeries are approximately the same or very similar. Taking into account the individuality of the disease and the patient’s condition, a competent doctor will definitely draw up a rehabilitation plan taking into account all indicators and to provide relief to the body.

Prohibited: any effect on the eyes, except medicinal, heaviness, intense physical activity and heavy food. Be sure to maintain a rest period during the week, avoid stress or traumatic situations. Strictly adhere to all the advice of your doctor and go to control appointments.

• You cannot use cosmetics for a month.
• Food and drink are strictly dietary. This regime also requires a period of one month.
• Beware of infections and colds.
• Wash your face for a month only with boiled water.
• Lift no more than 3 kilograms.

Regimes of drug use

Mandatory postoperative therapy is drops; this prevents inflammatory processes and disinfects the eyes. Medicines can be used independently or in combination.

The instillation scheme is strictly individual, but the treatment period is approximately the same for everyone - a month. This is if there were no complications. If the doctor decides that therapeutic treatment can be canceled, he will certainly notify you about this. It is prohibited to quit procedures on your own initiative!

Instillation procedure and rules of use drops:

• lying on your back;
• use a clean pipette;
• use the right number of drops;
• Use a clean cloth to prevent leakage.

Remember, your health depends on the cleanliness and sterility of items.

Visual loads (reading, computer)

No matter how avid a reader you are, you should forget about reading for a while, until you get permission from your doctor. Otherwise, you may face trouble in the form of a sharp increase in intraocular pressure; this is an unnecessary burden on the damaged organ.

The same goes for the computer. Overvoltage is strictly unacceptable, especially in the first weeks after surgery. Even watching TV from the right distance will have to be stopped until your eyes heal.

Driving

You are not allowed to drive a car for four weeks. If recovery proceeds properly, then the doctor may allow you to start driving earlier, but this is decided on an individual basis depending on personal indicators.

One way or another, but driving is required increased attention from the driver, and sharp rotating movements of the operated eyes, turning the head, all this will interrupt the healing process and create inconvenience while driving.

Physical activity and sports

At first, you shouldn’t even do exercises, since any rush of blood to the head increases the pressure, and this is a direct path to hemorrhage. Sudden movements can cause the lens to come loose, leading to disastrous results.

For two months you will have to forget about cycling, horses, jumping and running. Only after complete healing and permission from the ophthalmologist and a full examination, you can begin to do small exercises and return to a full life.

If you decide to resume sports activities earlier than your specialist allows, the problem of sore eyes may not only return, but also get worse.

Video

conclusions

Do not be self-willed and do not experiment with your health. The eyes are a very sensitive and delicate organ. Any sudden movement after surgery can deprive you of positive results and lead to complications.

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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 disinsertion. 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 does not happen often, it requires surgery.

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. Using 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 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 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 lead to 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. With it, bleeding develops from the affected 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 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.

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:

1. Intraoperative – occur during the work of surgeons.
2. 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

1. Swelling of the central zone of the retina.
2. 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 disinsertion

Consequences after cataract removal include such a serious complication as retinal detachment. Patients with myopia (myopia) are at risk. 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 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 experiences 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 GC-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 during 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.

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If you are healthy or your condition is compensated (your blood pressure, blood sugar levels are normal), vision recovery after cataract surgery should proceed smoothly and quickly. Statistics show that you have every chance to have excellent vision.

Uncomplicated cataract surgeries take approximately 10 minutes or less. But immediately after the operation, you need to rest, see how you feel after the anesthesia, and recover from the stress of the operation, even if you were not very worried. This usually takes from 30 minutes to 1 hour.

You should have someone take you home after surgery.
It may be that after the operation, when you return home, you will feel sleepy - this is normal. In this case, you need to sleep for several hours.

You will be able to remove the eye patch after a few days. After you remove the bandage, you should wear sunglasses for the first time to protect your eyes from blinding light.

How long will it take to restore vision after cataract surgery?

Do not be alarmed if, after surgery, you feel like you see objects as blurry, foggy, or distorted. It takes some time for the visual system to adjust to changes in it and to adapt to the new intraocular lens that you were given to replace your cloudy lens.

During the adaptation period, patients sometimes see floaters in front of their eyes and slight image distortions, which then go away.

Your eyes may also be red and inflamed due to slight damage to the blood vessels on the surface of your eye during surgery. These injuries will heal over time, and the eyes will become the same as they were before the operation.

Many patients report that they can see clearly within a few hours after surgery. But each person recovers differently. And sometimes it takes 1-2 weeks for a person to start seeing everything brightly and clearly.

Usually the surgeon who operated on you will invite you for a consultation the day after the operation to make sure there are no complications.

Your recovery after should last at least 1 month.

How to recover faster after cataract surgery? Tips for restoring vision.

You will be surprised how quickly you can return to normal activities the very next day after surgery. However, you must take all precautions during the entire period of subsequent rehabilitation to avoid the development of infection and speed up the healing of the eye.

To ensure a good recovery after surgery, you need to follow the following additional rules:

1. Don't drive on the first day.
2. Do not do heavy or strenuous work for several weeks.
3. After surgery, avoid bending or working in a tilted position to prevent pressure build-up inside the eye.
4. If possible, try not to sneeze or cough too much after surgery.
5. Be careful when moving indoors after surgery, do not bump into doors or wall corners.
6. To reduce the risk of infection, you should not swim in a pool or even lie in a warm bath for the first week after surgery (you can only shower carefully, making sure that neither water nor shampoo gets into your eyes).
7. Avoid wearing makeup for several weeks after surgery.
8. Wear a protective eye patch that will be placed around or over your eyes after surgery.

If you need cataract surgery on both eyes, your surgeon will usually wait at least a few days to four weeks after surgery on the first eye to repair it before performing the procedure on the second eye.

Phacoemulsification minimizes the risk of complications after lens replacement. Therefore, this operation is in great demand among ophthalmologists and patients. Phacoemulsification uses self-sealing incisions.

A reduction in the number of complications is caused by folding lenses or viscoelastics, which well protect the internal structures of the eye. With this procedure, it became possible to carry out the operation at any time. There is no need to wait for more favorable conditions.

Before the introduction of this technology, complications after cataract surgery occurred more frequently. This happened because it was necessary to wait for the lens to fully mature. In this state, it became denser, which complicated the process. Therefore, ophthalmologists believe that cataracts must be eliminated immediately. This factor contributed to the invention of phacoemulsification.

This is a new and safe method that has maximum effect in the treatment of cataracts. But any operation has its own certain risks of complications. More often noticed. The first sign of this complication is a cloudy appearance of the posterior capsule.

The frequency of occurrence of the secondary form depends on the material from which the replacement lens is made. When using IOLs made of polyacrylic, complications occur in 10% of cases. When using silicone lenses, consequences are observed in 40% of cases.

Most often, secondary cataracts occur when using lenses made of polymethyl methacrylate. The reasons for its appearance, as well as preventive measures, are still unknown. Scientists are trying to figure out how this effect occurs after lens replacement. This is known to occur due to the movement of epithelial tissues into the space that lies between the lenses and the posterior capsule.

Epithelium is the cells that remain when the lens is completely removed. They can form deposits that make the patient's vision blurry. It is believed that fibrosis of the lens capsule leads to the occurrence of secondary cataracts. In this case, the complication is eliminated using a YAG laser. They make a hole (in the center of the cloudy area).

This causes another complication - an increase in intraocular pressure (IOP). It occurs immediately after the intervention. It may occur due to incomplete washout of the viscoelastic. This is a substance that protects the internal structures of the eye. The cause of increased IOP after cataract removal may be a shift of the IOL towards the iris. But this phenomenon can be easily eliminated if you use glaucoma drops for 2-3 days.

Other negative phenomena

Irvine-Gass syndrome, or cystoid macular edema, occurs in 1% of cases. But when using the extracapsular technique, the likelihood of pathology occurring increases to 20%. There is a risk group for this complication that includes diabetics, people with uveitis and wet AMD.

The likelihood of occurrence increases if the posterior capsule is ruptured during cataract extraction. After the lens is removed, a complication may arise in the event of vitreous loss. You can get rid of the pathology with the help of corticosteroids, non-steroidal anti-inflammatory drugs, angiogenesis inhibitors. If conservative treatment does not give the desired effect, vitrectomy is prescribed.

The eye may swell after lens replacement. This complication is called ocular edema. It occurs when the pumping function of the endothelium is damaged during surgery. Damage can be either chemical or mechanical in nature.

During swelling of the eye, a person sees blurred. But with a favorable outcome, the complication goes away on its own.

But the development of pseudophakic bullous keratopathy can also occur. This process is characterized by the presence of bubbles in the cornea. To eliminate them, hypertonic solutions and ointments are prescribed. It is possible to use therapeutic contact lenses. If therapy does not help, the cornea will need to be replaced.

Foggy eyes can also appear with astigmatism. The postoperative type of the disease occurs after IOL implantation. The complexity of astigmatism directly depends on the method used to eliminate the cataract. The severity is influenced by the length of the incision, its location, the presence of sutures and problems encountered during the operation.

If the degree of astigmatism is small, then it can be corrected with glasses or lenses. But when the eye is watery and the degree of astigmatism is high, it is necessary to perform refractive surgery.

In rare cases, a complication such as IOL displacement occurs. According to statistics, the percentage of manifestation of this complication is very small even several years after the operation. Contributing factors are:

• weakness of the cyanogen ligaments;
• pseudoexfoliation syndrome.

Other pathologies

- A common occurrence during IOL implantation. Its occurrence is associated with various problems discovered during surgery. The appearance of pathology is facilitated by the presence of diabetes mellitus, myopic refraction, and previous surgical intervention.

In most cases, this disease is caused by intracapsular cataract extraction. Less commonly, the cause is extracapsular cataract extraction. But the smallest percentage of cases of such a complication is observed during phacoemulsification. To detect this complication early after surgery, it is necessary to periodically visit an ophthalmologist. This condition is treated in the same way as other detachments.

During the operation, unforeseen complications may occur, which include choroidal hemorrhage. Blood pours out from the nutrient vessels of the retina. This condition is observed with hypertension, a sudden increase in IOP, atherosclerosis, and aphakia. The cause of the disease may be an eyeball that is too small, old age, or an inflammatory process.

The bleeding may stop on its own. But there are cases when it led to complex consequences, as a result of which patients lost an eye. It is necessary to apply complex therapy to eliminate bleeding. Additionally, corticosteroids, cycloplegic and mydriatic drugs, and antiglaucoma drugs are prescribed. Sometimes surgery is indicated.

If cataract surgery is performed, complications may present in the form of endophthalmitis. They can cause, which leads to its absolute loss. According to statistics, the frequency of occurrence is 0.13-0.7%

Factors contributing to the occurrence of pathology include wearing contact lenses, a prosthetic fellow eye, and the use of immunosuppressive therapy. If an infectious process has begun in the organ, it is manifested by severe redness of the eye, increased photosensitivity, painful sensations and deterioration of vision.

For prophylaxis, preoperative administration of 5% povidone-iodine is indicated. Additionally, an antibacterial agent is injected into the eye. The quality of disinfection of the instrument used for surgery plays an important role.

Reasons for the development of negative phenomena

Many patients are interested in why, despite the high level of safety, complications appear. This is explained by the fact that any interference in the activity and integrity of the body is stressful for the patient. Moreover, each complication has its own mechanism of occurrence.

Swelling of the eye can appear not only in the postoperative period, but also before the procedure. More often it is caused by weakness of the cornea. If swelling appears after surgery, a reaction to ultrasound may occur. If you have to treat already advanced cataracts, it is necessary to use stronger sound waves. This also causes an increased effect on the eyeball.

If the operation is performed without stitches, swelling is minor and does not require any treatment. Once the shape of the eye is restored and the swelling disappears, vision will be restored. It is possible that there will be a burning sensation and pain in the eye. To alleviate this condition, you must follow your doctor’s recommendations:

• You can’t lower your head (until the doctor’s permission);
• avoid driving;
• while sleeping, lie on the side of your healthy eye;
• avoid physical overexertion;
• prevent water from getting in while taking a bath;
• protect the eye from mechanical damage.

Lens replacement surgery is a fairly safe intervention, the postoperative period of which goes quite smoothly if you follow all the doctor’s recommendations

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