What are the Most Common Postoperative Complications After Cataract Surgery?

Cataract surgery is a common and generally safe procedure, but it can come with certain postoperative complications. Cystoid macular edema (CME) is the most frequent complication after uncomplicated cataract surgery, with a peak incidence of 6 to 8 weeks after the operation. Optical coherence tomography (OCT) is the standard method for diagnosing and monitoring CME, although fluorescein angiography can also be used. Infections can occur if germs enter the eye during surgery, and symptoms such as light sensitivity, pain, redness, and vision problems should be monitored.

In some cases, antibiotics may need to be injected into the eye or the vitreous gel removed to prevent the infection from spreading. Retinal detachment is another potential complication of cataract surgery. The retina, located at the back of the eye, detects light and sends messages to the brain. After surgery, there is a slightly increased risk of retinal detachment.

This usually resolves on its own within a few months, but if any symptoms such as light sensitivity or vision problems occur, an exam should be scheduled with a doctor right away. Swelling, bleeding, or leftover fragments of the lens can cause increased pressure on the eye, which can lead to glaucoma. In some cases, this resolves on its own with sunglasses; however, it could also be a sign of another problem and eye drops may be necessary. This is the most common complication of most cataract surgeries and appears up to 8 weeks after the procedure.

It occurs in 1 to 2 percent of all cataract surgeries. Hemorrhagic choroid detachments are another potential complication of cataract surgery that can occur during virtually any intraocular procedure or rarely as a complication of trauma. Endophthalmitis is a rare but serious complication of cataract surgery with a possible devastating effect on a person's quality of life. Laser cataract surgery has been shown to reduce this risk by making precise self-sealing corneal incisions; arched incisions to reduce astigmatism; highly circular, strong and well-positioned capsulorhexis; and removing the cataract in a safer and less technically difficult way. If local or topical anesthesia is used for cataract removal, patients can go home soon after surgery.

Intracameral phenylephrine has been used as an effective tool for preventing intraoperative flaccid iris syndrome in patients taking tamsulosin (142A). Tamsulosin has been associated with intraoperative flaccid iris syndrome and subsequent complications of cataract surgery; treatment strategies to reduce harm include topical atropine before surgery, iris retractors, pupil expansion rings or viscoadaptive ophthalmic devices (141c).Up to half of people who have cataract surgery will experience some increase in eye pressure after the procedure; however, pressure levels usually return to normal within 24 hours. In a retrospective evaluation of cataract surgery in men exposed to tamsulosin or alfuzosin, there was a significantly higher risk of suffering from intraoperative flaccid iris syndrome with tamsulosin (139c).

Mattie Cournoyer
Mattie Cournoyer

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