2020–2021 BCSC Basic and Clinical Science Course™
11 Lens and Cataract
Chapter 10: Intraoperative Challenges in Cataract Surgery
This chapter includes related videos. Go to www.aao.org/bcscvideo section11 or scan the QR codes in the text to access this content.
Posterior capsule rupture is the most common serious intraoperative complication of phacoemulsification.
Patients with intraoperative floppy iris syndrome have an increased risk of surgical complications.
Because a continuous curvilinear capsulorrhexis (CCC) resists radial anterior capsule tears and helps stabilize the nucleus and the intraocular lens (IOL), any discontinuity of the CCC can complicate the remainder of the cataract extraction and IOL placement.
In cases of posterior capsule rupture, vitreous loss can be reduced by reducing fluid inflow and stabilizing the anterior chamber with an ophthalmic viscosurgical device (OVD) prior to removing instruments from the main incision.
Vitreous loss should be managed preferably with bimanual vitrectomy, not with pulling and external cutting.
Expulsive suprachoroidal hemorrhage is one of the most devastating intraoperative complications and can result in vision loss.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.