Surgery Side Effects: Cataract surgery is one of the oldest procedures and, at the same time, one of the most frequent in medical practice, with some side effects. From the first attempts to restore vision in cataract patients to current state-of-the-art techniques, the number of complications from this surgery has been reduced . However, some still persist with minimal frequency.
Surgery Side Effects: Cataracts are one of the main ophthalmological conditions of the elderly . In this pathology, various degrees of opacity appear in the lens, a natural intraocular lens that allows light to pass through to the retina to observe the world around us. This function is possible thanks to the transparency of the lens, so that the opaque areas generate a decrease in visual acuity.
Proper preparation for preventing cataract surgery side effects
Surgery Side Effects: Preoperative evaluation is essential for any surgery. And this reality is not different for ophthalmology.
Surgery Side Effects: A thorough assessment allows us to recognize the risk factors of each patient , anticipating various situations, both in surgery and in recovery from it. Similarly, preoperative evaluation is essential to choose the best surgical approach in each case.
Surgery Side Effects: There are conditions that must be taken into account, since they increase the probability of side effects in cataract surgery. Therefore, being able to identify them is vital for the success of the procedure. Likewise, the clarity with which the information is provided to the patient avoids unrealistic expectations .
Surgery Side Effects: Among the conditions that increase the risk of complications in cataract surgery are the following:
- Diabetic retinopathy.
- Arterial hypertension.
- Pseudoexfoliation syndrome .
- Defects in pupil dilation.
Surgery Side Effects: In addition, during the surgery itself, some undesirable situations may occur that affect the results. These complications are even less frequent and depend in part on the technique used.
Surgery Side Effects: However, the higher probability of occurrence in patients with risk factors shows that intraoperative complications are directly related to the preoperative situation.
Surgery Side Effects: Let’s see, then, the side effects that are most recorded in cataract surgery. The first 5 that we will tell you about are after the surgical act and the final 3 refer to those complications that already appear at the time of the intervention.
1. Posterior Capsule Opacity (PCO)
Surgery Side Effects: This is the main complication in cataract surgery and is the cause of a decrease in visual acuity by triggering blurred vision. The posterior capsule of the lens is one of the structures left during extraction surgery, as it supports the intraocular lens.
Origin of the complication
Surgery Side Effects: Posterior capsule opacity occurs when cells that are shed during the procedure remain residual . The migration of these elements to the capsule, which has a conformation that gives it transparency, hinders the passage of light.
Correction of the adverse effect
Surgery Side Effects: Capsulotomy using YAG laser technology is the first treatment choice for posterior capsule opacity. However, it is a procedure that is performed if the visual alteration is significant, which is evidenced by the slit lamp.
The results are excellent, but like any procedure, it has some risks:
- Transient increase in intraocular pressure.
- Intraocular lens subluxation .
- Edema macular.
2. Increased intraocular pressure
Surgery Side Effects: Another cause of blurred vision after cataract surgery is increased intraocular pressure (IOP), which is usually transient. Among the causes, the molecular weight of the material used in the intervention, the location of the intraocular lens and the use of steroid drops after surgery are described.
Surgery Side Effects: The increase in IOP can be prevented by the postoperative indication of drugs that lower intraocular pressure , either orally or topically. However, patient follow-up is essential, as some require prolonged antiglaucoma medication and even further surgery.
3. Foreign body in the operated eye
Surgery Side Effects: A frequent complication is the presence of an intraocular foreign body after cataract surgery. Its material is variable, the following being described in the literature:
- Metallic remains
- cotton fibers
- Plastic waste
- Cellular remains of the intervention
- Intraocular lens fragments
Surgery Side Effects: The review of the team, both prior to surgery and at the end, as well as a thorough postoperative examination, reduce the frequency of this complication. In general, the removal of the foreign body is recommended , since depending on the type of material and its location, it can trigger major problems:
- Eye hypertension .
- Fragment mobilization injury.
4. Retinal detachment
Surgery Side Effects: After cataract surgery there is an increased risk of retinal detachment when compared to the general population. The symptoms include the presence of small spots that float in the visual field, known as floaters (myodesopsia) , the sensation of light flashes (photopsia) and the progressive loss of vision as a curtain.In the face of these symptoms, an urgent ophthalmological evaluation should be sought.
5. Endophthalmitis: one of the most feared complications
Surgery Side Effects: One cause of pain and red eye is endophthalmitis , an infection of the eyeball. This occurs when microorganisms enter through the surgical incision , colonizing the interior of the eye.
Surgery Side Effects: Aseptic measures are fundamental in its prevention, as is the indication of topical antibiotics prior to surgery. Treatment must be started immediately, since it compromises visual capacity.
6. Capsular rupture
Surgery Side Effects: Although it is one of the side effects described during cataract surgery, and the first that we name of the 3 that are intraoperative, this complication is quite unusual . Among its causes are the laceration of the posterior capsule by the instruments used during the procedure and even the trauma generated when placing the intraocular lens.
Surgery Side Effects: It is a serious complication , since repair is a surgical challenge. In particular, because it usually occurs in patients with underlying conditions that are difficult to manage. Furthermore, capsular rupture leads to other undesirable effects, such as retinal detachment and macular edema.
7. Zonular dialysis
Surgery Side Effects: Zonular dialysis is a rare complication in cataract surgery, being more frequent in patients with risk factors. To repair this zonule injury, placement of a tension ring to secure the lens is recommended.
8. Suprachoroidal hemorrhage
Surgery Side Effects: A rare complication in current surgeries is suprachoroidal hemorrhage. The rupture of blood vessels by the incision leads to an increase in intraocular pressure with exit of the ocular content through the same wound. Stopping bleeding immediately during surgery is key.
Other side effects of cataract surgery
Surgery Side Effects: Although rare, intraoperative complications lead to a poor outcome of the intervention . For this reason, preoperative assessment is so important.
Surgery Side Effects: Similarly, a higher frequency of this type of complication during cataract surgery has been confirmed in developing countries. This is due to the technological limitations that these populations have and the restricted access to training and updating.
Surgery Side Effects: As in any surgical act, symptoms may appear during the recovery period due to the manipulation of the ocular structures. These include pain, foreign body sensation, and dry eye. Likewise, the medication administered can trigger transient adverse effects.