Knowledge is Essential for Avoiding Complications Associated with Glued Intraocular Lens Surgery
Pseudophakia is the presence of an artificial intraocular lens that is placed in the eye after cataract surgery. The natural lens of the eye is removed through surgery and replaced with an artificial intraocular lens implant.
Glued Intraocular Lens surgery is designed to restore pseudophakia in patients where the posterior capsule of the eye is not able to support an intraocular lens. While any type of surgery poses risk of complications, risks can be dramatically reduced by improving knowledge about specific techniques used in glued Intraocular Lens surgery.
To begin with, it is imperative to avoid any and all distractions during surgery, since even a minor distraction can result in a negative outcome. In addition, surgeons should be prepared to address any cataract surgery complications that may arise as proficiently as possible.
The outcome of glued intraocular lens surgery also requires proper maintenance of the eye infusion. In particular, viscoelastic should never be used to inflate the eyeball. A trocar cannula or an anterior chamber can be used to maintain infusion in the eye. Viscoelastic should only be used for protecting the endothelium and when loading the foldable Intraocular Lens.
Problems such as cystoids macular edema may occur if the vitreous is mishandled during the procedure. This complication occurs most commonly during exteriorization of the haptic or vitrectomy.
Additionally, if the haptic is not tucked properly into the sclera, haptic extrusion may result. In this case, it is possible to prevent this complication by creating a new tunnel allowing the surgeon to tuck and glue the haptic properly.
Thorough sterilization during surgery is essential. For instance, complications such as endophthalmitis may occur during glued Intraocular lens surgery due to improper sterilization. Therefore, stringent measures should be taken to maintain proper sterilization throughout the surgical process.
If the wound is improperly closed or the surgeon does not inject air into the eye after the surgery is complete, complications such as choroidal detachment or hypotony may result. If, for example, hypotony is present, then the surgeon should make a fluid injection into the eye via the clean corneal incision. This will ensure that the fluid reaches the vitreous cavity in order to distend it and reduce the complication.
In order to avoid secondary glaucoma, the intraocular lens must be elevated after surgery due to any potential postoperative inflammation or residual viscoelastic.
As long as thorough knowledge of the procedure is gained before surgery and all possible complications are addressed, glued intraocular lens surgery can be performed with a great amount of success.