9
Retinal Detachment
Î Risk factors for development of retinal detachment after cataract
surgery include axial length >23 mm (especially high myopia),
posterior capsule tear, vitreous loss, younger age, male gender,
lattice degeneration, zonular dehiscence, retinal detachment in the
fellow eye, and the new onset of a postoperative posterior vitreous
detachment.
Suprachoroidal Hemorrhage
Î The majority of published studies support the continuation of
anticoagulant and antiplatelet therapy during cataract surgery when
performed by a skilled surgeon. (I-, G, S)
Cystic Macular Edema
Î There is no level I evidence that visual outcome is improved by the
routine use of prophylactic NSAIDs at 3 months or more after cataract
surgery. (II+, M, S)
Intraocular Pressure
Î Corticosteroid cessation usually results in a reduction of the IOP to
normal levels, and the IOP should be monitored in patients treated
with postoperative corticosteroid medication. (II-, G, S)
Complications of Intraocular Lenses
Î When an unacceptable or intolerable refractive error results following
IOL implantation, the risks of surgical intervention must be weighed
against the alternatives of eyeglass or contact lens correction. (III, G, S)
• Surgical alternatives to IOL exchange include keratorefractive surgery and
secondary ciliary sulcus implantation of a pigg yback IOL.
Posterior Capsular Opacification (PCO)
Î The decision to perform capsulotomy should take into account the
benefits and risks of the laser surgery. (III, G, S)
Î Laser posterior capsulotomy should not be performed prophylactically
(i.e., when the capsule remains clear). (III, G, S)
Î The eye should be inflammation-free and the IOL stable prior to
performing Nd:YAG laser capsulotomy. (III, G, S)
Î In high-risk patients, the surgeon should monitor the IOP in the early
postoperative period. (III, G, S)
