Cataract surgery types and per, early post op and late post op complications

CATARACT SURGERY TYPES AND ITS

COMPLICATIONS

Presented by:

MUHAMMAD NABEEL

TYPES OF CATARACT SURGERY• Intra Capsular Cataract Extraction (ICCE)• Extra Capsular Cataract Extraction (ECCE)• Small Incision Cataract Surgery (SCIS)• Phacoemulsification

ECCE

ICCE

Intra Capsular Cataract Extraction (ICCE)

Extra Capsular Cataract Extraction (ECCE)

Small Incision Cataract Surgery (SCIS)

Phacoemulsification

COMPLICATIONS OF CATARACT SURGERY

Per Operative Complications• Bridle Suture Perforation of the globe

• Stripping of Descemet’s Membrane

• Damage to ciliary body

• Rupture of posterior capsule

Without vitreous lossWith vitreous loss

• Posterior loss of lens fragmentation

• Suprachoroidal hemorrhage Source Long or short ciliary arteriesContributing factors sudden rise in IOP, vitreous loss, coughing, sudden

rise in blood pressureSigns shallowing of anterior chamber, increase IOP, iris prolapse, vitreous

extrusion, loss of red reflex, in severe cases all intra ocular contents are extruded out

Treatment immediate, subsequent

Early Post-operative Complications

Iris prolapse Striate keratopathy Hyphema Wound leak

• Acute Bacterial Endophthalmitis

Vision threatening complicationCausative organisms most commonly staph epidermidis, staph aureus,

pseudomonasSource air borne infections, objects, medications and solutions, tissuesPreoperative prophylaxis treatment of pre-existing infections, instillation of

povodine-iodine, meticulous draping, post operative injection of antibioticsTime interval depends on the pathogen involved . (staph aureus 1st to 3rd day,

staph epidermidis 4th to 10th day)

Clinical features:• Symptoms Pain , redness, watering, diminished visual acuity• Signs

Management of acute bacterial endophthalmitis• Preparation of intravitreal injections

• Identification of causative organisms

• Intravitreal injections of antibiotics

• Steroids

• Vitrectomy - only if VA is PL

• Subsequent therapy

Late Post-operative Complications • Chronic endophthalmitis

Causative organisms propionibacterium acnes, staph epidermidisTreatment steroids, antibiotics, removal of IOL and posterior capsular bag

• Posterior capsule opacification Elshing pearl Capsular fibroisis

Treatment Nd:YAG laser capsulotomy

• Malpositioning of IOL

Decentration Optic capture

• Retinal detachmentRisk factors include

• Lattice degeneration• Disruption of posterior capsule• Vitreous loss• If post operative laser capsulotomy is performed

• Corneal decompensation

THANK YOU ICCE