After cataract removal, the edges of the lens are visible. Complications after cataract surgery

01.07.2017

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

Types of pathologies after surgery

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

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

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

Postoperative complications are represented by the following types:

Uveitis.
Pressure (intraocular).
Displacement of the lens.

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

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.

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Consequences and complications after cataract surgery

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. At risk are patients with myopia (myopia). According to research, the incidence of retinal detachment is about 3-4%.

Intraocular lens displacement

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.

The postoperative period associated with lens replacement is characterized by a number of possible complications and risks.

Complications

Posterior capsule rupture. The complication is one of the serious ones, as it is characterized by loss of the vitreous body, displacement of the lens substance and bleeding, which manifests itself impulsively. If treatment for this complication is not started on time, consequences such as a pulled-up pupil, sudden opacities of the vitreous body, secondary glaucoma, displacement of the artificial lens, and artificial retinal detachment are possible.

Depending on the stage at which the gap occurred and its size, the actions to eliminate the consequences depend. Basic rules include:

in order to prevent the formation of a vitreous hernia, viscoelastic is injected in order to bring them into the anterior part of the eye chamber;
in order to close the gap in the lens capsule, tonsils are introduced beyond the mass line of the lens substance;
Using a vitreotome, it is necessary to remove all the vitreous substance from the anterior part of the eye chamber.

Due to this complication, a problem arises in the implementation of the intraocular lens. Here you need to know that if the lens substance gets in, an artificial lens cannot be installed for the reason that it can harm and interfere with the visual perception of the fundus.

Posterior prolapse of the lens masses. Dislocation of parts of the lens into the vitreous body occurs during the rupture of the capsule; it is very rare, but this period of complications can lead to glaucoma, retinal detachment, chronic uveitis, as well as macular edema. To cope with the loss of the lens substance, it is necessary to urgently treat glaucoma and uveitis, and then vitrectomy and removal of all parts of the lens must be performed.

As for the timing for removing the consequences of this complication, opinions differ. Some experts believe that it is necessary to perform an operation to remove the remnants of the lens within one week, while other doctors adhere to the point of view that treatment related to the normalization of intraocular pressure and the removal of uveitis is first necessary, and after three weeks the eye is cleaned of lens masses.

Posterior dislocation of the intraocular lens. Posterior displacement of the intraocular lens is primarily due to improper lens implantation. This complication can lead to retinal detachment, vitreal hemorrhage, and cystic edema. Treatment consists of vitrectomy or complete intraocular lens replacement.

Suprachoroidal hemorrhage. This complication manifests itself in the early postoperative period and is associated with bruising in the suprachoroidal space. It may be associated with impulsive bleeding and, in complex cases, be characterized by loss of substances from the eyeball. Hemorrhage is possible in older people, people suffering from glaucoma, and heart disease.

Signs of suprachoroidal hemorrhage are:

a sharp increase in the level of IOP, iris prolapse forms, and a process of grinding of the anterior chamber is observed;
the appearance of a dark gray spot in the pupil area after the vitreous fluid has leaked.

To deal with the hemorrhage, the incision must be closed; specialists perform a posterior sclerotomy and then prescribe a course of systemic steroids.

Corneal edema can most often be relieved. It is associated with the procedure itself, as a result of which the lens is replaced and occurs as a result of endothelial injuries that occur upon contact with the intraocular lens or operating instruments.

Iris prolapse. The iris falls out in cases of operations with small incisions. The main signs of complications are uneven scarring of the wound, astigmatism, cystoid macular edema and epithelial ingrowth.

Vision treatment in this case is associated with intervals between operations. If a complication is detected within two days after surgery, then the stitches are simply re-stitched if there is no infection. If the operation took place a long time ago, then an excision of the area of the iris that has fallen out is performed.

Cystoid retinal edema. Edema develops after surgery, which occurred with complications. It is due to the fact that the capsule ruptures and the vitreous body falls out. Most often, this complication appears several months after surgery.

Rehabilitation period of recovery

Lens replacement involves following certain rules after surgery to restore vision. They are common.

Therefore, if your operation is associated with individual characteristics, then the ophthalmologist can assign an individual rehabilitation schedule and duration of the recovery period.

Regimen: After cataract treatment, it is not necessary to remain in bed. You only need to remember that you should not sleep on the side where the operation was performed and on your stomach for the first three to four days after replacing the eye lens with an intraocular lens.

Hygiene: Avoid getting soap or water in your eyes when bathing or washing your face. If water does get into the eye on which the operation was performed, it is necessary to rinse it with a 02% furatsilin solution.

Bandage. It is recommended to wear it during the first days after replacing the lens with a lens. The bandage can protect the operated eye from exposure to sunlight and bright artificial lighting, as well as from microelements that are in the air. To make a regular bandage, you need to fold the gauze in two layers and attach it to your forehead with an adhesive plaster.

Experts use eye drops to ensure that wounds heal quickly and there are no inflammatory processes that can lead to infection.

Most often, drops are prescribed according to the following scheme: in the first week, drip 4 times a day, in the second – 3 times, in the third – 2 times, and so on, until the drops do not need to be dripped at all.

After some time, the rules and restrictions will be lifted. But you need to follow a few simple tips that will allow you to completely restore your vision within a short period of time and maintain it in the future:
do not rub your eye or put pressure on it;
If possible, wear sunglasses to protect your eyes from direct exposure to ultraviolet rays;

Now you know everything about the complications that can occur after cataract removal and lens replacement, the rehabilitation period and the rules that must be followed to restore visual acuity and maintain healthy eyes.

Types of pathologies after surgery

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

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

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

Postoperative complications are represented by the following types:

Uveitis.
Pressure (intraocular).
Displacement of the lens.

Postoperative complications

Cataract (secondary).

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Contents of the article: classList.toggle()">toggle

Cataract is an ophthalmological disease characterized by complete or partial clouding of the lens, which reduces visual acuity and even leads to blindness.

Is it possible to cure cataracts without surgery? Treatment of this pathology is carried out only by surgery.

Types of surgical intervention, contraindications, rehabilitation period - more on this later.

What is cataract and how does the disease manifest?

The lens is an important part of the optical system of the eye; it is responsible for focusing the image on the retina. When this natural lens becomes cloudy, images become blurry.

Most often, cataracts occur due to the natural aging of the lens, but sometimes the disease develops in young people.

Due to natural aging, nuclear cataracts occur in the center of the lens. It impairs vision, contributes to the development of myopia, and the patient has difficulty distinguishing shades. The lens turns yellow and its consistency becomes dense.

Nuclear cataract has the following symptoms :

(myopia);
Diplopia (double vision);
Problems with ;
Blurred vision.

Congenital cataract Diagnosed in a child immediately after birth, this disease has the following symptoms:

The gaze does not focus on the object;
(strabismus).

Secondary cataract is a consequence of unsuccessful eye surgery, it has the following symptoms:

Deterioration of vision;
Lack of image clarity and brightness;
Diplopia.

Immature cataract is a senile vision disorder that manifests itself with the following symptoms:

Changes in the structure and optical properties of the lens;
Veil before the eyes;
Decreased visual acuity.

Surgical methods

Cataracts can only be treated with surgery. Types of surgical intervention:

Intracapsular extraction is a procedure during which the doctor removes the lens and its capsule. The main indication is post-traumatic cataract. A cryoextractor (cryosurgical instrument) is used to remove the lens and replace it with an artificial lens. Cataract surgery is prohibited for patients under 17 years of age due to the structural features of the eye;
Phacoemulsification– a surgical intervention during which the damaged lens is replaced with an artificial one. Using an ultrasound probe, the damaged lens is broken into small particles and sucked out. Advantages: the procedure is painless, there are no stitches, low risk of infection. Cataract surgery with lens replacement is performed in patients with diabetes mellitus, corneal dystrophy, ;
Extracapsular extraction- an operation during which the nucleus of the lens is removed and the capsule is left. An incision is made in the eye, the lens is completely removed, and at the end the doctor puts stitches. Disadvantages: the sutures may cause vision problems, the patient takes a long time to recover, and there is a risk of the suture coming apart. The operation is prohibited for children with infectious and inflammatory processes or cancer;
Femtosecond laser– the damaged lens is broken using a femtosecond laser. Advantages: the cornea is not damaged, the likelihood of complications is low. for surgery: clouding of the cornea, overripe cataract.

The doctor selects the type of operation depending on the type of disease and the age of the patient. You can find out how to treat cataracts without surgery.

Patient preparation

In order for the operation and rehabilitation period to be successful, the patient needs to properly prepare for the procedure. It is not recommended to eat or drink 8 hours before surgery. Otherwise, nausea, vomiting, and dyspepsia may occur. Before going to bed, you can take a natural sedative, such as motherwort, to help you relax and unwind.

Before the procedure, it is forbidden to use Aspirin and Coumadin, as these drugs thin the blood and can cause intraocular bleeding.

It is necessary to purchase in advance all the medications that are needed to care for the eye during the recovery period. The doctor will provide a list of medications.

If you have chronic diseases, be sure to tell your doctor about them.

In the hospital you cannot do without replacement shoes, socks, and a robe. You will also need documents (passport and agreement on payment for the operation).

Before surgery, the affected eye will be treated with anesthetic drops that dilate the pupil. This drug causes a slight decrease in visibility and a feeling of slight numbness in the eye.

2-3 days before the procedure, the ophthalmologist will describe the surgical plan and select the most suitable lens for you. Before surgery, it is recommended to consult with an anesthesiologist to choose the method of pain relief.

After cataract surgery, the patient can go home, so you need to invite a person to accompany you in advance.

Carrying out the operation

Phacoemulsification is the most popular, effective and reliable operation for removing a clouded lens. This procedure can be performed at any time and there is no need to wait for the cataract to “mature.”

After all, this is a rather long process that disrupts the usual rhythm of life: due to cataracts, many people lost their jobs, refused to drive a car, and experienced discomfort in poor lighting.

Ultrasonic sutureless phacoemulsification occurs in several stages:

Now you know how cataract surgery works. There is no need for stitches after the operation, as the incision is very small and heals on its own.. Good visibility appears immediately after the procedure, and visual acuity is restored within 7 days.

Rehabilitation after cataract surgery

The postoperative period when replacing the lens of the eye during cataract removal includes the use of an eye patch, which performs a protective function. Most patients feel well and go home immediately after the procedure. But before that, the ophthalmologist will examine you and give recommendations. If there is a risk of complications, the patient is kept in the hospital overnight.

During the recovery period after cataract surgery, you need to treat your eyes with drops that will speed up healing. Tilt your head back, pull back your lower eyelid, drop in 2 drops, close your eye and rotate your pupil for a few seconds so that the product is evenly distributed. Pinch the inner corner of your eye to prevent the medication from leaking out.

Your doctor will determine which eye drops are best after cataract surgery. If your doctor has prescribed you several medications, the interval between their use should be at least 5 minutes. To prevent infection from entering the eye, do not touch the eye with the dropper.

Ophthalmologists strongly recommend wearing bandages to protect the eye from bright light and various injuries. This can be done using disposable dressings. You can also make such a bandage yourself.

To do this, take a bandage and a patch, stick it horizontally on the bandage. Place a bandage of stiffer fabric on top and secure it to your head.

After the operation, the doctor will tell you when the patient needs to come for an examination. After some time, all restrictions are lifted. In most cases, the implant remains transparent forever. If its back wall begins to become cloudy, which happens very rarely, then visual function is restored surgically.

14 days after the procedure, the patient must visit an ophthalmologist who will evaluate the condition of the eye. During the healing period, you need to constantly use eye drops to avoid infectious and inflammatory diseases. Visual function is restored after a week, after which the patient needs to choose corrective glasses.

You can learn about medications for the treatment of cataracts.

Recommendations for lifestyle and behavior after cataract surgery

In order for visual function to recover faster, the patient must follow the recommendations and restrictions after eye cataract surgery:

Secondary cataracts and other complications

The patient's condition after cataract lens replacement surgery must be constantly monitored. Otherwise The following complications may occur after eye cataract surgery:

Secondary cataracts occur several months or years after surgery. The reason is that defective harmful cells of the damaged lens remain in the eye, which are very difficult to completely remove;
IOP increases due to ocular trauma during the procedure, disease, genetic predisposition, or excessive physical activity;
Retinal detachment occurs because the doctor was not careful. This complication can also be caused by damage to the eye before surgery or the presence of certain diseases in the patient;
The lens is displaced as a result of a medical error or an incorrectly selected size of an artificial lens;
Bleeding into the anterior chamber occurs due to incorrect actions of the doctor, poor-quality installation of the implant, and excessive physical exertion;
The retina swells due to non-compliance with eye care rules after surgery, previous eye injury or other diseases.

To avoid complications, strictly follow your doctor's recommendations and use drops regularly.