Complications of cataract surgery that result in permanent loss of vision are rare, thanks to the advent of modern surgical techniques and technology, in the hands of experienced cataract surgeons. Posterior capsule rupture is the most common serious intraoperative complication of phacoemulsification (reported in 0.3%–3.5% of cases). The incidence of severe adverse events after cataract surgery, including endophthalmitis, suprachoroidal hemorrhage, and retinal detachment, has declined over the past several decades. Postoperative complications are discussed in Chapter 11.
Minimizing intraoperative complications begins with surgical planning and preparation. As discussed in Chapters 7 and 12, it is critical to make sure that the patient is comfortable in order to avoid complications due to excessive or inadvertent patient motion. The function of instruments and devices to be used in the eye should always be checked prior to surgery. A loose cannula can become a projectile in the anterior chamber (Video 10-1); a retracted irrigation sleeve can slip external to the incision; or a detached irrigation tube from the phacoemulsification handpiece can cause a sudden collapse of the anterior chamber. Some complications are mild and self-limited; others are severe and vision-threatening (Table 10-1).
Projectile in anterior chamber. Courtesy of Charles Cole, MD.
Go to www.aao.org/bcscvideo_section11
to access all videos in Section 11.
American Academy of Ophthalmology Cataract/Anterior Segment Panel, Hoskins Center for Quality Eye Care. Preferred Practice Pattern® Guidelines. Cataract in the Adult Eye—2016. American Academy of Ophthalmology; 2016. www.aao.org/ppp
Stein JD. Serious adverse events after cataract surgery. Curr Opin Ophthalmol. 2012;23(3): 219–225.
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.