What not to do after eye surgery Old age is not a hindrance to cataract treatment

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

Types of surgical interventions

Among the types of surgical intervention to restore vision, the main ones can be distinguished, these are laser treatment, such as scleroplasty and vicrectomy. All operations have their own characteristics and warnings, always the final decision 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 rises greatly. Glaucoma may only go away for a certain amount of time, symptoms may return, so other methods are required to treat more serious diseases.
Scleroplasty aims to fix the upper layers of the eyeball, which allows. This method is also well developed and refers to simple interventions. It does not carry any serious consequences, the patient is operated on under local anesthesia.
Vitrectomy is a complex type of surgery that is performed on an outpatient basis, and takes a rather long period, about three hours, in the absence of complications. During the process, the surgeon removes the tissues affected by the disease, the destructive fibers of the vitreous body, and in especially severe cases, the vitreous body is removed completely. As a replacement, a special liquid or silicone filling is used.

Laser correction

You need to lie down, because standing up to do the procedure is impossible.

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

If it was severe, the doctor may require bandage wearing, this helps to 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.

The eyes in the postoperative period may turn red, tearing may increase, but these symptoms will disappear after a few days, you should be patient. In order to monitor the progress of recovery, appointments are made to visit the doctor, so the plan should act rigorously:

Inspection after manipulation.
A week later.
A month later and beyond. There may be an individual scheme for everyone.

Rules for the behavior of the patient 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 the internal organs can cause complications, the eyes are no exception, which is why it is so important to follow the doctor's instructions. However, cases of negative consequences are not uncommon, they may appear as:

Hemorrhages.
Infections.
Puffiness.
Increased pressure inside the eye.
Displacement of the lens.

There may be more complications, some of them 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 assistance falls on the shoulders of the clinic in which 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 recovery.

For several hours, the patient must lie down at rest on his back.
Do not touch your eyes or use homemade eyewash unless prescribed by a doctor. Any raw water that enters the eye can cause inflammation or infection.
In order to prevent dust from getting on the eye surface, you should wear goggles from the sun and dust.
Any heaviness is harmful at this time and overexertion can cause an increase in pressure or rupture of blood vessels.

Basal laser as an effective treatment for glaucoma.

It is worth saying that all recommendations after eye operations 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 alleviate the body.

Forbidden: any effect on the eyes, except for medicinal, heaviness, increased physical activity and heavy food. Be sure to observe the rest mode during the week, avoid stress or traumatic situations. Strictly adhere to all the advice of the attending physician and go to control visits.

You can not use cosmetics for a month.
Food and drink strictly dietary. This mode also requires a monthly period.
Watch out for infections and colds.
Wash for a month only with boiled water.
Lift no more than 3 kilograms.

Drug regimens

Mandatory postoperative therapy are drops, it prevents inflammation and disinfects the eyes. Medicines can be used independently and in combination.

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

The order of instillation and rules of use drops:

in the supine position;
use a clean pipette;
use the right amount of drops;
apply a clean cloth against leakage.

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

Visual loads (reading, computer)

No matter how avid reader you are, you should forget about reading for a while, until such time as there is permission from the 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 stop until your eyes heal.

Driving

Driving is not allowed for four weeks. If the recovery is proceeding properly, then the doctor may be allowed to drive earlier, but this is already 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, head turns, all this will stop the healing process and create inconvenience while driving.

Physical activity and sports

At first, you should not even do exercises, since any rush of blood to the head increases pressure, and this is a direct path to hemorrhage. Due to sudden movements, the lens can be released, and this will lead to disastrous results.

For two months you will have to forget about the bike, horses, jumping and running. Only after complete healing and the permission of the ophthalmologist and a full examination, you can start doing small exercises and return to a full life.

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

Video

conclusions

Do not be self-willed and do not experiment on 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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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 a 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 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 concerned about visual aberrations, glare, and monocular diplopia.

The displacement of the intraocular lens mainly occurs during surgery. May be due to dialysis of the zonum ligament, rupture of the capsule, and may 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 "lattice" 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

If you are healthy or your condition is compensated (you have blood pressure, blood sugar levels are normal), recovery of vision after cataract surgery should be smooth and fast. As statistics show, you have every chance to have excellent eyesight.

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

You must have a person who will drive you home after the operation.
It may be that after the operation, when you return home, you will want to sleep - this is normal. In this case, you need to sleep a few hours.

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

How long does it take to recover vision after cataract surgery?

Do not be alarmed if after the operation it seems to you that you see objects blurry, foggy, distorted. It takes some time for the visual system to adjust to the changes in it and to adapt to the new intraocular lens that you have been fitted to replace your cloudy lens.

During the adaptation period, patients sometimes see floating flies before their eyes and small image distortions, which then disappear.

Also, your eyes may well be red and inflamed, this is due to a slight damage to the blood vessels on the surface of your eye during the operation. Over time, these injuries will heal, 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 in their own way. And sometimes it takes 1-2 weeks for a person to begin to see everything brightly and clearly.

Usually the surgeon who operated on you will invite you for a consultation the next 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.

In order for the recovery after the operation to go well, you need to follow the following additional rules:

Do not drive the car on the first day.
Avoid heavy or strenuous work for several weeks.
After surgery, avoid bending over, work in a tilt to prevent the pressure inside the eye from rising.
If possible, try not to sneeze or cough heavily after surgery.
Be careful when moving indoors after surgery, do not bump into doors and wall corners.
To reduce the risk of infection, you can not swim in the pool or even lie in a warm bath during the first week after the operation (you can only take a gentle shower, making sure that neither water nor shampoo gets into your eyes).
Do not wear make-up for several weeks after surgery.
Wear a protective eye patch that will be placed around or over your eyes after surgery.

If you need cataract surgery in both eyes, your surgeon will usually wait at least a few days to four weeks after surgery on the first eye in order 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. In phacoemulsification, self-sealing incisions are used.

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

Prior to the introduction of this technology, complications after cataract surgery were more common. This happened because it was necessary to wait for the full maturation of the lens. In this state, it was compacted, which complicated the process of carrying out. Therefore, ophthalmologists believe that cataracts must be removed immediately. This factor contributed to the invention of phacoemulsification.

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

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

The most common secondary cataract occurs when using lenses made of polymethyl methacrylate. The causes of its occurrence, as well as preventive measures are still unknown. Scientists are trying to find out the principle of the occurrence of this effect after the replacement of the lens. It is known that this is due to the movement of epithelial tissues into the space that is located between the lenses and the posterior capsule.

Epithelium - cells that remain during the complete removal of the lens. They can form deposits, against which the patient will see blurry. It is believed that fibrosis of the lens capsule leads to the occurrence of secondary cataract. In this case, the complication is eliminated with the help of a YAG laser. They make a hole (in the center of the cloudy zone).

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

Other negative phenomena

Irwin-Gass syndrome, or cystoid macular edema, occurs in 1% of cases. But during the use of extracapsular techniques, the likelihood of pathology increases to 20%. There is a risk group for this complication, which includes diabetics, people with uveitis and wet AMD.

The likelihood of occurrence increases if the posterior capsule ruptured during cataract extraction. After the lens is removed, a complication may arise in case of loss of the vitreous body. 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, vitreectomy is prescribed.

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

During swelling of the eye, a person sees indistinctly. But with a favorable outcome, the complication goes away by itself.

But pseudophakic bullous keratopathy may also develop. 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.

Fog in the eyes can also appear with astigmatism. The postoperative form of the disease occurs after IOL implantation. The complexity of astigmatism directly depends on the method by which the cataract was eliminated. The severity is affected by the length of the incision, its localization, the presence of sutures and the problems encountered during the operation.

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

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

weakness of cyan ligaments;
pseudoexfoliative syndrome.

Other pathologies

is a common occurrence during IOL implantation. Its occurrence is associated with various problems that were discovered during the operation. The appearance of pathology is facilitated by the presence of diabetes mellitus, myopic refraction, and previous surgery.

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

During the operation, unforeseen complications may occur, which include choroidal hemorrhage. Blood is poured out of the nutrient vessels of the retina. Such a condition is observed with hypertension, a sudden rise in IOP, atherosclerosis, aphakia. The cause of the disease can be too small an eyeball, old age, an inflammatory process.

The bleeding may stop on its own. But there are cases when it led to the most difficult consequences, against which patients lost an eye. It is necessary to apply complex therapy to eliminate bleeding. In addition, corticosteroids, cycloplegic and mydriatic drugs, antiglaucoma drugs are prescribed. Sometimes surgery is indicated.

If a cataract is operated on, complications can be presented 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%

Contributing factors to the onset of pathology are the wearing of contact lenses, a fellow eye prosthesis, and the use of immunosuppressive therapy. If an infectious process has begun in the organ, it is manifested by a pronounced reddening of the eye, increased photosensitivity, pain and visual impairment.

For prevention, a preoperative installation of 5% povidone-iodine is indicated. Additionally, an antibacterial agent is injected into the eye. An important role is played by the quality of disinfection of the instrument used for the operation.

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 with the activity and integrity of the body is stressful for the patient. Moreover, each complication has its own mechanism of occurrence.

Puffiness of the eye can appear not only in the postoperative period, but also before the manipulation. More often it is caused by weakness of the cornea. If edema appears after surgery, a reaction to ultrasound may be observed. If you have to treat an already advanced cataract, you need to use stronger sound waves. This also causes an increased effect on the eyeball.

If the operation is performed without sutures, the swelling is negligible and does not require any treatment. As soon as 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 the doctor's recommendations:

you can not lower your head (until the permission of the doctor);
avoid driving;
during sleep, lie on the side of a healthy eye;
give up physical stress;
avoid water ingress while taking a bath;
protect the eye from mechanical damage.

The operation to replace the lens is a fairly safe intervention, the postoperative period of which goes quite smoothly if all the doctor's recommendations are followed.