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Manual Small Incision Cataract Surgery :
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POSTOPERATIVE COMPLICATIONS |
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Immediate complications
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Wound leak
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Corneal complications (edema, SK, DM stripping)
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Postoperative iritis
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Postoperative increased IOP
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Endophthalmitis
Late complications
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Corneal: (edema, SK, DM stripping)
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Uveitis
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Capsular bag complications
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IOL malpositions
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Posterior capsular opacification
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CME
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Endophthalmitis
Postoperative wound dehiscence
Predisposing factors:
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Excessive episcleral cautery
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Tearing or buttonholing of roof of the tunnel
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Premature entry, shallow entry
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Nuclear/cortical fragment in tunnel
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Incorrect suture placement
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Postoperative rise in IOP
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Predisposing diseases[collagen vascular disease]
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Leaking paracentesis wound
Manifests as:
Wound rupture is very rare after manual SICS
Management:
Corneal complications
Corneal edema, SK, bullous keratopathy, DM stripping & recurrent corneal erosions.
Rx of corneal edema:
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Control inflammation {Topical steroids}
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Cycloplegics
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Treat the presence of epithelial defect
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Antiglaucoma medications
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Hyperosmotic agents
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Wait for sometime before going for PKP [at least 3 months]
Uveitis
Due to:
1. Excessive surgical manipulation (nucleus prolapse & during extraction of nucleus)
2. Any residual cortical matter
Management:
Postoperative rise of I.O.P
Due to retained viscoelastics.
Increased size of capsular bag -- viscoelastic material gets locked up between posterior surface of PC IOL & posterior capsule
Rx
- Topical antiglaucoma medications
- If IOP rise is persistent -- medical or surgical Rx
Posterior segment complications
- Retinal detachment
- Posterior dislocation of IOL
- Vitreous hemorrhage
- Vitritis
- Ant. ischemic optic neuropathy
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