Cataract Surgery: Surgical Techniques & Complications
Ophthalmology High-Yield Essentials
1. Surgical Procedures
| Procedure | Mechanism |
|---|---|
| Phacoemulsification | Ultrasonic energy fragments the lens; contents are aspirated through a small (2.2–2.8mm) incision. |
| SICS | Manual “Small Incision Cataract Surgery.” The lens is expressed whole through a larger self-sealing scleral tunnel incision. |
| ECCE / ICCE | Larger incisions; ICCE (Extracapsular) is rarely performed today, and ECCE is mostly reserved for very hard, mature cataracts. |
2. Common Complications
- Intraoperative:
- Posterior Capsular Rent (PCR): The most dreaded complication, leading to vitreous loss.
- Zonular dialysis: Dislocation of the lens capsule support.
- Suprachoroidal Hemorrhage: Rare but sight-threatening (“Expulsive hemorrhage”).
- Postoperative:
- Endophthalmitis: Severe intraocular infection (Ocular emergency).
- Cystoid Macular Edema (CME): Most common cause of reduced vision post-op (Irvine-Gass syndrome).
- Posterior Capsular Opacification (PCO): The most common long-term complication (“After-cataract”). Treated with YAG laser capsulotomy.
3. NEET PG High-Yield Pearls
- PCO Management: Nd:YAG laser is the gold standard for treating PCO (clouding of the posterior capsule).
- Irvine-Gass Syndrome: Cystoid macular edema occurring after cataract surgery; confirm via OCT.
- Endophthalmitis: Look for hypopyon and severe vitreous haze. Immediate vitrectomy and intravitreal antibiotics are required.
- Repository: For detailed surgical flowcharts and clinical images of these complications, consult the resources available at mymedschool.org.