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CATARACT SURGERY TYPES AND ITS
COMPLICATIONS
Presented by:
MUHAMMAD NABEEL
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TYPES OF CATARACT SURGERY• Intra Capsular Cataract Extraction (ICCE)• Extra Capsular Cataract Extraction (ECCE)• Small Incision Cataract Surgery (SCIS)• Phacoemulsification
ECCE
ICCE
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Intra Capsular Cataract Extraction (ICCE)
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Extra Capsular Cataract Extraction (ECCE)
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Small Incision Cataract Surgery (SCIS)
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Phacoemulsification
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COMPLICATIONS OF CATARACT SURGERY
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Per Operative Complications• Bridle Suture Perforation of the globe
• Stripping of Descemet’s Membrane
• Damage to ciliary body
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• Rupture of posterior capsule
Without vitreous lossWith vitreous loss
• Posterior loss of lens fragmentation
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• 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
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Early Post-operative Complications
Iris prolapse Striate keratopathy Hyphema Wound leak
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• 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)
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Clinical features:• Symptoms Pain , redness, watering, diminished visual acuity• Signs
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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
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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
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• Malpositioning of IOL
Decentration Optic capture
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• Retinal detachmentRisk factors include
• Lattice degeneration• Disruption of posterior capsule• Vitreous loss• If post operative laser capsulotomy is performed
• Corneal decompensation
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THANK YOU ICCE