Advances in cataract surgery bring new complications along with benefits

Cataract surgical techniques and IOLs have both been evolving for many years. The advances have been-and continue to be-tremendous, but each new advance also has the potential to give birth to new complications. The need to suture clear corneal incisions to prevent potentially blinding complications during subsequent surgery, and the dislocation of one-piece IOLs and capsular tension rings, are examples of complications of which practitioners need to be aware.

Key Points

New techniques in cataract surgery can offer wonderful benefits to patients, yet they also can present new complications and challenges, said Gregg Kokame, MD, speaking here at the World Ophthalmology Congress (WOC).

For example, clear corneal incision minimizes astigmatism and stabilizes IOP, but it carries with it a risk of leakage and hypotony, according to Dr. Kokame, medical director of the Retina Center at Pali Momi and clinical professor, division of ophthalmology, University of Hawaii School of Medicine, Honolulu.

New complications

Cataract surgical techniques have evolved as posterior chamber IOL designs have evolved. New complications, however, have arisen along with the new designs, and the designs can have an effect on the management of complications, he said. "Dislocated IOLs are an uncommon but recurring problem throughout the history of IOL implantation, and they can present a surgical management challenge," Dr. Kokame said. "Unfortunately, dislocations are becoming increasingly frequent, with unusual presentations, as surgical techniques and IOL designs have changed."

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