Management
14
Prior keratoplasy • Poor visualization
• Graft rejection or failure
• IOL-power calculation inaccuracy
• Hyperopic shift in association with Descemet stripping
endothelial keratoplasty (DSEK)
Prior scleral buckling
surgery
• Change in axial length affects IOL power calculation
• Conjunctival scarring
• Increased risk of sclera perforation with injection
anesthesia
Pseudoexfoliation • Zonular laxity
• Poor pupil dilation
• Elevated IOP after surgery
Relative anterior
microphthalmos
• Damage to iris, cornea. and posterior capsule
• IOL-power calculation inaccuracy
Shallow anterior
chamber
• Iris injury
• Iris prolapse
• Postoperative corneal edema
Use of systemic
sympathetic alpha-1a
antagonist medication
for treatment of prostatic
hypertrophy and other
systemic conditions
• Poor pupillary dilation, intraoperative miosis, iris billowing
and prolapse
White cataract (mature
cortical cataract)
• Difficulty performing the capsulorrhexis (capsule staining
may be helpful)
• Lens intumescence
• Radial capsulorrhexis tear with extension into posterior
capsule
Zonular laxity or
dehiscence (e.g., trauma)
• Phacodonesis
• Vitreous prolapse around the lens equator
• Capsular rupture with retained lens fragments
• Fluid misdirection syndrome
• Postoperative lens implant decentration
• Increased risk of radial capsulorrhexis tear
• Capsular contraction with late IOL/capsular bag
decentration or dislocation
Table 5. High-Risk Characteristics for Intraoperative and
Postoperative Complications (cont'd)
High-Risk
Characteristic Special Considerations
