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Refractive Enhancements After Cataract Surgery
Key Points There can be several contributing factors to a refractive surprise after cataract surgery, such as incorrect intraocular lens (IOL) calculations as a result of keratometry and/or axial length measurements, postrefractive surgery eyes, or toric IOL rotation (see Chapter…
Management of Dysphotopsia
Key Points Dysphotopsias (positive, negative, and diffractive optic) represent undesirable subjective optical phenomena that may occur after uncomplicated, seemingly “perfect” cataract surgery. They are, in part, related to IOL design and IOL position. Positive dysphotopsia (PD) is described by patients…
Neodymium:Yttrium-Aluminum-Garnet Laser Applications in the Cataract Patient
Key Points Posterior capsular opacification is very common after cataract extraction. Nd:YAG laser capsulotomy is the treatment of choice. Nd:YAG laser can also be used to perform laser peripheral iridotomy and anterior hyaloid vitreolysis to address pupillary block glaucoma. For…
Subluxated Intraocular Lenses
Key Points Detailed ocular examination in patients with subluxated IOLs is a must, including undilated gonioscopy and dilated slit lamp evaluation to reveal the status of the zonules, capsular bag, and any endocapsular device in situ. Subluxated IOLs may result…
Retinal Complications of Cataract Surgery
Key Points It is important for the cataract surgeon to assess for preoperative and intraoperative risk factors for retinal complications. The anterior segment surgeon can take several key steps during and after surgery to maximize visual outcomes despite the occurrence…
Glaucoma After Cataract Surgery
Key Points Clear corneal phacoemulsification generally reduces intraocular pressure (IOP) in glaucoma and ocular hypertensive eyes. A list of differential diagnoses should exist in the minds of all cataract surgeons when evaluating patients with elevated IOP after cataract surgery. Immediate…
Corneal Edema After Cataract Surgery
Key Points The etiology of postoperative corneal edema is broad. Thorough preoperative evaluation can help elicit patients at higher risk for postoperative corneal edema. Corneal edema can lead to acute and chronic changes in visual acuity and to eye pain.…
Surgical Instrument Care and Toxic Anterior Segment Syndrome
Key Points All personnel involved in the handling of intraocular surgical instruments should adhere to established protocols to ensure that the instruments are safely prepared for use. Although many general principles of cleaning and sterilization of surgical instruments apply to…
Issues in Wound Management
Introduction The cataract incision serves as more than just the access point to the anterior segment. It affects corneal stability and overall ocular integrity. Wound construction is the critical determinant of this integrity, and two key elements of the wound…