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. The lens It’s crystalline. Cross section: 1. Capsule 2. Cortex 3.

nucleus
. 2. Ciliary muscle •Function: • Constricts ciliary body • Relaxes tension on lens • Lens become spherical,
which increase the refractive power Ciliary process •Attaches to the lenses by suspensory ligament (zonular
fibers) •Secrete the Aqueous humor into the post. chamber
. 3. DEFINITION • A cataract is a clouding or capacity that develops in the crystalline lens of the eye or in its
envelope, varying in degree from slight to capacity and obstructing the passage of light. • The term cataract is
derived from the Greek word cataractos, which describes rapidly running water or falling water.
. 4. Epidemiology 1. Cataracts remain the leading cause of blindness. 2. Age-related cataract is responsible
for 48% of world blindness, which represents about 18 million people. 3. Cataracts are also an important
cause of low vision in both developed and developing countries.
. 5. Causes of cataract • Old age (commonest)>65 Year • Ocular & systemic diseases – DM – Uveitis –
Previous ocular surgery • Systemic medication – Steroids – Phenothiazines • Trauma & intraocular foreign
bodies • Ionizing radiation – X-ray – UV • Congenital – Part of a syndrome – Abnormal galactose metabolism
– Hypoglycemia • Inherited abnormality – Myotonic dystrophy – Marfan’s syndrom – Rubella – High myopia 8
. 6. Any physical or chemical cause ↓ Disturbs the intracellular and extracellular equilbrium of water and
electrolytes ↓ Deranges the colloid system in lens fibres ↓ Aberrant fibres are formed from germinal
epithelium of lens ↓ Epithelial cell necrosis ↓ Focal opacification of lens epithelium (glaucomflecken) ↓
Opacification of lens PATHOMECHANISM
. 7. Opacification of lens takeplace by 3 biochemical changes. 1. Hydration 2.Denaturation of 3.Slow lens
protein sclerosis Abnormalities of lens proteins & Disorganisation of lens fibres Loss of transparency of lens
Cataract
. 8. CLASSIFICATION : BASED ON : •MORPHOLOGY •AGE OF ONSET •MATURITY •ETIOLOGY
. 9. Cataract Divided to : • Acquired cataract Age - related cataract Metabolic cataract Radiation or electric
cataract Traumatic cataract Toxic cataract Secondary cataract
. 10. AGE OF ONSET: 1.CONGENITAL 2.INFANTILE 3.JUVINILE 4.PRE-SENILE 5.SENILE
. 11. CONGENITAL CATARACT
. 12. INFANTILE AND JUVINILE CATARACT
. 13. Age -related cataract It is the Most commonly occurred. Classified according to: Morphological
Classification •Capsular cataract •Sub capsular cataract •Cortical cataract •Supra nuclear cataract •Nuclear
cataract •Polar cataract
. 14. Nuclear cataract • Most common typeMost common type • Age-relatedAge-related • Occur in theOccur
in the centercenter ofof the lens.the lens. • It involves the nucleusIt involves the nucleus of the crystalline
lens.of the crystalline lens. The nucleus becomesThe nucleus becomes diffusely cloudy anddiffusely cloudy
and obstructs the light rays.obstructs the light rays.
. 15. Cortical cataract • Occur on the outer edge of the lens (cortex). • Begins as whitish, wedge-shaped
opacities. • The lens fibers of the cortex are mainly affected. There is hydration due to accumulation of water
droplets in between the fibers and the protein are first denaturated and then are coagulated forming opacity.
. 16. Subcapsular cataract •It involves superficial part of the cortex(just below the capsule) and includes
anterior sub capsule or posterior sub capsule. capsular cataract • It involves the capsule and may be anterior
capsule or posterior capsule.
. 17. MATURITY: 1.IMMATURE CATARCT 2.MATURE CATARACT 3.HYPERMATURE CATARACT
. 18. MATURE AND IMMATURE CATARACT
. 19. Mature Cataract • Lens is completely opaque. • Vision reduced to just perception of light • Iris shadow is
not seen • Lens appears pearly white Right eye mature cataract, with obvious white opacity at the centre of
pupil
. 20. IMMATURE CATARACT
. 21. Hypermature Cataract • Shrunken and wrinkled anterior capsule due to leakage of water out of the lense.
• This may take any of two forms: 1.Liquefactive/Morgagnian Type 2.Sclerotic Cataract
. 22. Liquefactive/Morgagnian Type • Cortex undergoes auto-lytic liquefaction and turns uniformly milky white.
• The nucleus loses support and settles to the bottom.
. 23. Sclerotic Cataract • The fluid from the cortex gets absorbed and the lens becomes shrunken. • There
may be deposition of calcific material on the lens capsule. • Iridodonesis: Anterior chamber deepens and iris
becomes tremulous. • The zonules become weak, increasing the risk of subluxation / dislocation of lens.
. 24. SUBJECTIVE CLASSIFICATION: • GRADE 0: CLEAR LENS • GRADE 1: SWOLLEN FIBRES AND
SUB CAPSULAR OPACITIES • GRADE 2: NUCLEAR CATARACT AND VISIBLE LENS FIBRES • GRADE 3:
STRONG NUCLEAR CATARACT WITH PERINUCLEAR AREA OPACITY • GRADE 4: TOTAL OPACITY
. 25. SUBJECTIVE CLASSIFICATION
. 26. Clinical Manifestations •Gradual painless burning •Loss of vision due to lens opacity •Increased glare in
bright light •Decreased color perception •Decreased visual acuity •Poorvision at night •
Photophobia(lightPhotophobia(light sensitivity)sensitivity) • Blurred or distorted imagesBlurred or distorted
images • Light scatteringLight scattering • Leukokoria or white pupilLeukokoria or white pupil • Reduced light
transmissionReduced light transmission • Contrast sensitivity is alsoContrast sensitivity is also lostlost
. 27. BLURRED VISION DUE TO SCATTERING OF LIGHT ON THE RETINA
. 28. GLARED VIEW(TROUBLE DRIVING AT NIGHT)
. 29. CHANGE IN COLOUR VISION(DIMNESS)
. 30. 1. History collection 2. Visual acuity test 3. Dilated eye exam 4. Tonometry
. 31. Treatment • Glasses: Cataract alters the refractive power of the natural lens so glasses may allow good
vision to be maintained. • Surgical removal: when visual acuity can't be improved with glasses. • Surgical
techniques –Phacoemulsification method. –Extracapsular cataract extraction. –Intra capsular cataract
extraction. –Intraocular lens implantation –cryosurgery
. 32. Phacoemulsification in cataract surgery involves insertion of a tiny, hollowed tip that uses high frequency
(ultrasonic) vibrations to "break up" the eye's cloudy lens (cataract). The same tip is used to suction out the
lens .
. 33. Intra-capsular Cataract Extraction Intracapsular Cataract Extraction. From the late 1800s until the 1970s,
the technique of choice for cataract extraction was intracapsular cataract extraction (ICCE). The entire lens
(ie, nucleus, cortex, and capsule) is removed, and fine sutures close the incision. ICCE is infrequently
performed today; however, it is indicated when there is a need to remove the entire lens, such as with a
subluxated cataract (ie, partially or completely dislocated lens).
. 34. Extra-capsular Cataract Extraction (ECCE) • Extracapsular Surgery. Extracapsular cataract extraction
(ECCE) achieves the intactness of smaller incisional wounds (less trauma to the eye) and maintenance of
the posterior capsule of the lens, reducing postoperative complications, particularly aphakic retinal
detachment and cystoid macular edema.
. 35. Postoperative care after cataract surgery • Steroid drops (inflammation) • Antibiotic drops (infection) •
Avoid • Very strenuous exertion (rise the pressure in the eyeball) • Ocular trauma.
. 36. Complications of cataract surgery • Infective endophthalmitis – Rare but can cause permanent severe
reduction of vision. – Most cases within two weeks of surgery. – Typically patients present with a short history
of a reduction in their vision and a red painful eye. – This is an ophthalmic emergency. – Low grade infection
with pathogen such as Propionibacterium species can lead patients to present several weeks after initial
surgery with a refractory uveitis • Suprachoroidal haemorrhage. – Severe intraoperative bleeding can lead to
serious and permanent reduction in vision.
. 37. • Uveitis • Ocular perforation. • Postoperative refractive error • Posterior capsular rupture and • vitreous
loss
. 38. Retinal detachment. Cystoid macular oedema Glaucoma Posterior capsular opacification
. 39. Nursing diagnosis • Anxiety related to lack of knowledge about post operative care. • Risk for infection
related to surgical incision and self care after surgery. • Risk for injury related to sensory deficit while
operated eye is patched.

1. cataract is an opacity of the lens that distorts image projected onto the
retina and that can progress to blindness.

2. The lens opacity reduces visual acuity. As the eye ages, the lens loses
water and increases in size and density, causing compression of lens fibers.
A cataract then forms as oxygen uptake is reduced, water content
decreases, calcium content increases, and soluble protein becomes insoluble.
3. Intervention is indicated when visual acuity has been reduced to a level
that the client finds to be unacceptable or adversely affects lifestyle.
4. Over time, compression of lens fibers causes a painless, progressive loss
of transparency that is often bilateral. The rate of cataract formation in
each eye is seldom identical.

Causes

 Cataracts have several causes and may be age-related, present at birth,


or formed as a result of trauma or exposure to a toxic substance. The most
common cataract is age-related (senile cataract). Traumatic cataracts
develop after a foreign body injures the lens. Complicated cataracts develop
as secondary effects in patients with metabolic disorders (e.g., diabetes
mellitus), radiation damage (x-ray or sunlight), or eye inflammation or
disease (e.g., glaucoma, retinitis pigmentosa, detached retina, recurrent
uveitis). Toxic cataracts result from drug or chemical toxicity. Congenital
cataracts are caused by maternal infection (e.g., German measles, mumps,
hepatitis) during the first trimester of pregnancy.

Complications

 Complications may include retinal disorders, pupillary block, adhesions,


acute glaucoma, macular edema, and retinal detachment. Following
extracapsular cataract extraction, the posterior capsule may become
opacified. This condition, called a secondary membrane or after-cataract,
occurs when subcapsular lens epithelial cells regenerate lens fibers, which
obstruct vision. After-cataract is treated by yttrium-aluminum-garnet
(YAG) laser treatment to the affected tissue. Without surgery, a cataract
eventually causes complete vision loss.

Assessment
1. Opaque or cloudy white pupil
2. Gradual loss of vision
3. Blurred vision
4. Decreased color perception
5. Vision that is better in dim light with pupil dilation
6. Photophobia
7. Absence of the red reflex

Primary Nursing Diagnosis

 Sensory and perceptual alterations (visual) related to decreased visual


acuity

Other Diagnoses that may occur in Nursing Care Plans For Cataract

 Anxiety
 Deficient knowledge (diagnosis and treatment)
 Risk for infection
 Risk for injury

Diagnostic Evaluation
 General Comments: No specific laboratory tests identify cataracts.
Diagnosis is made by history, visual acuity test, and direct ophthalmoscopic

exam.
 Ophthalmoscopy or slit lamp examination may reveal a dark area in the
red reflex. Ophthalmoscopy or slit lamp examination is a microscopic
instrument that allows detailed visualization of anterior segment of eye to
identify lens opacities and other eye abnormalities

Medical Management

There is no medical treatment for cataracts, although use of vitamin C and E


and beta-carotene is being investigated. Glasses or contact, bifocal, or
magnifying lenses may improve vision. Mydriatics can be used short term, but
glare is increased.

Surgical Management

 Surgical removal of the opacified lens is the only cure for cataracts. The
lens can be removed when the visual deficit is 20/40.
 If cataracts occur bilaterally, the more advanced cataract is removed
first.
 Extracapsular cataract extraction, the most common procedure,
removes the anterior lens capsule and cortex, leaving the posterior capsule
intact. A posterior chamber intraocular lens is implanted where the
patient’s own lens used to be.
 Intracapsular cataract extraction removes the entire lens
within the intact capsule. An intraocular lens is implanted in
either the anterior or the posterior chamber, or the visual
deficit is corrected with contact lenses or cataract glasses.


Extracapsular cataract extraction

 Complications may include retinal disorders, pupillary block, adhesions,
acute glaucoma, macular edema, and retinal detachment. Following
extracapsular cataract extraction, the posterior capsule may become
opacified. This condition, called a secondary membrane or after-cataract,
occurs when subcapsular lens epithelial cells regenerate lens fibers, which
obstruct vision. After-cataract is treated by yttrium-aluminum-garnet
(YAG) laser treatment to the affected tissue.

Pharmacologic Highlights

 Acetazolamide a carbonic anhydrase inhibitor is used to reduce


intraocular pressure by inhibiting times a day inhibitor formation of
hydrogen and bicarbonate ions.
 Phenylephrine a Sympathomimetic agent causes abnormal dilation of
the pupil constriction of conjunctival arteries.
 Other Medications: Postoperatively, medications are prescribed to
reduce infection (gentamicin or neomycin) and to reduce inflammation
(dexamethasone), taking the form of eye drops. Acetaminophen is
prescribed for mild discomfort; tropicamide is prescribed to induce ciliary
paralysis.
Nursing Interventions

1. If nursing care is provided in the patient’s home, structure the


environment with conducive lighting and reduce fall hazards.
2. Suggest magnifying glasses and large-print books. Explain that
sunglasses and soft lighting can reduce glare.
3. Assist the patient with the actions of daily living as needed to remedy
any self-care deficit.
4. Encourage the patient to verbalize or keep a log on his or her fears and
anxiety about visual loss or impending surgery.
5. Help plan events to solve the problems with social isolation.

Documentation Guidelines

 Presence of complications: Eye discharge, pain, vital sign alterations


 Response to eye medication
 Reaction to supine position

Discharge and Home Healthcare Guidelines

 Be sure the patient understands all medications, including dosage, route,


action, adverse effects, and need for postoperative evaluation, usually the
next day, by the eye surgeon. Review installation technique of eye drops
into the conjunctival sac. Teach the patient to avoid over-the-counter
medications, particularly those with aspirin.
 Instruct the patient to report any bleeding, yellow-green drainage, pain,
visual losses, nausea, vomiting, tearing, photophobia, or seeing bright
flashes of light. Instruct the patient to avoid activities that increase
intraocular pressure such as bending at the waist, sleeping on the
operativeside, straining with bowel movements, lifting more than 15
pounds, sneezing, coughing, or vomiting. Instruct the patient to wear a
shield over the operative eye at night to prevent accidental injury to the
eye during sleep and to wear glasses during the day to prevent accidental
injury to the eye while awake. Recommend that the patient avoid reading
for some time after surgery to reduce eye strain and unnecessary
movement so that maximal healing occurs.
 Advise the patient not to shampoo for several days after surgery. The
face should be held away from the shower head with the head tilted back
so that water spray and soap avoid contact with the eye.

HOME HEALTH TEACHING

 Vacuuming should be avoided because of the forward flexion and rapid,


jerky movement required.
 Driving, sports, and machine operation can be resumed when
permission is granted by the eye surgeon.
 Clients fitted with cataract eyeglasses need information about altered
spatial perception. The eyeglasses should be first used when the patient is
seated, until the patient adjusts to the distortion.
 Instruct the client to look through the center of the corrective lenses
and to turn the head, rather than only the eyes, when looking to the side.
Clear vision is possible only through the center of the lens. Hand-eye
coordination movements must be practiced with assistance and relearned
because of the altered spatial perceptions.

. he lensIt’s crystalline. Histology: 1. Capsule 2. Subcapsular epithelium (simple cuboidal). • Synthesize


protein for lens fiber • Maintains a cation pump to keep the lens clear 1. Lens fibers Cross section: 1. Capsule
2. Cortex 3. nucleus
. 3. Ciliary muscle •Function: • Constricts ciliary body • Relaxes tension on lens • Lens become spherical,
which increase the refractive power Ciliary process •Attaches to the lenses by suspensory ligament (zonular
fibers) •Secrete the Aqueous humor into the post. chamber
. 4. DEFINITION • Any congenital or acquired opacity(dullness) in the lens or lens capsule is called as
cataract
. 5. Epidemiology 1. Cataracts remain the leading cause of blindness. 2. Age-related cataract is responsible
for 48% of world blindness, which represents about 18 million people 3. Cataracts are also an important
cause of low vision in both developed and developing countries.
. 6. Causes of cataract • Old age (commonest) • Ocular & systemic diseases – DM – Uveitis – Previous ocular
surgery • Systemic medication – Steroids – Phenothiazines • Trauma & intraocular foreign bodies • Ionizing
radiation – X-ray – UV • Congenital – Part of a syndrome – Abnormal galactose metabolism – Hypoglycemia
• Inherited abnormality – Myotonic dystrophy – Marfan’s syndrom – Rubella – High myopia 7
. 7. Any physical or chemical cause ↓ Disturbs the intracellular and extracellular equilbrium of water and
electrolytes ↓ Deranges the colloid system in lens fibres ↓ Aberrant fibres are formed from germinal
epithelium of lens ↓ Epithelial cell necrosis ↓ Focal opacification of lens epithelium (glaucomflecken) ↓
Opacification of lens PATHOMECHANISM
. 8. Opacification of lens takeplace by 3 biochemical changes. 1. Hydration 2.Denaturation of 3.Slow lens
protein sclerosis Abnormalities of lens proteins & Disorganisation of lens fibres Loss of transparency of lens
Cataract
. 9. Cataract Divided to : • Acquired cataract Age - related cataract(Senile Cataract) Presenile cataract
Traumatic cataract Drug induced cataract Secondary cataract • Congenital Cataract Systemic association
Non-systemic association
. 10. Age -related cataract It is the Most commonly occurred. Classified according to: Morphological
Classification • Nuclear • Cortical • Subcapsular • Christmas tree – uncommon Maturity classification •
Immature Cataract • Mature Cataract • Hypermature Cataract
. 11. Nuclear cataract • Most common type • Age-related • Occur in the center of the lens. • In its early stages,
as the lens changes the way it focuses light, patient may become more nearsighted or even experience a
temporary improvement in reading vision. Some people actually stop needing their glasses. • Unfortunately,
this so-called 2nd sight disappears as the lens gradually turns more densely yellow & further clouds vision. •
As the cataract progresses, the lens may even turn brown. Advanced discoloration can lead to difficulty
distinguishing between shades of blue & purple.
. 12. Cortical cataract • Occur on the outer edge of the lens (cortex). • Begins as whitish, wedge-shaped
opacities or streaks. • It’s slowly progresses, the streaks extend to the center and interfere with light passing
through the center of the lens. • Problems with glare are common with this type of cataract.
. 13. Subcapsular cataract • Occur just under the capsule of the lens. • Starts as a small, opaque area • It
usually forms near the back of the lens, right in the path of light on its way to the retina. • It’s interferes with
reading vision • Reduces vision in bright light • Causes glare or halos around lights at night.
. 14. Posterior Subcapsular Cataracts • Begins at the back of the lens (posterior pole) & spreads to the
periphery or edges of the lens. • It can be developed when: – Part of the eye are chronically inflamed. –
Heavy use of some medications (steroids). • Affects vision more than other types of cataracts because the
light converges at the back of the lens. • Anything constrict the pupils (bright light) makes it very difficult for
people with this type of cataract to see. • Dilating drops useful in this type by keeping the pupils large and thus
allow more light into the eye.
. 15. 17
. 16. Immature Cataract Lens is partially opaque Two morphological forms are seen: 1.Cuneiform Cataract: –
Wedge shaped opacities in the peripheral cortex and progress towards the nucleus. – Vision is worse in low
ambient illumination when the pupil is dilated. 1.Cupuliform Cataract: – A disc or saucer shaped opacities
beneath the posterior capsule. – Vision is worse in bright ambient illumination when the pupil is constricted.
Lens appears grayish white in color. Iris shadow can be seen on the opacity with oblique illumination.
. 17. Mature Cataract • Lens is completely opaque. • Vision reduced to just perception of light • Iris shadow is
not seen • Lens appears pearly white Right eye mature cataract, with obvious white opacity at the centre of
pupil
. 18. Hypermature Cataract • Shrunken and wrinkled anterior capsule due to leakage of water out of the lense.
• This may take any of two forms: 1.Liquefactive/Morgagnian Type 2.Sclerotic Cataract
. 19. Liquefactive/Morgagnian Type • Cortex undergoes auto-lytic liquefaction and turns uniformly milky white.
• The nucleus loses support and settles to the bottom.
. 20. Sclerotic Cataract • The fluid from the cortex gets absorbed and the lens becomes shrunken. • There
may be deposition of calcific material on the lens capsule. • Iridodonesis: Anterior chamber deepens and iris
becomes tremulous. • The zonules become weak, increasing the risk of subluxation / dislocation of lens.
. 21. Symptoms • A cataract usually develops slowly, so: –Causes no pain. –Cloudiness may affect only a
small part of the lens –People may be unaware of any vision loss. • Over time, however, as the cataract
grows larger, it: –Clouds more the lens –Distorts the light passing through the lens. –Impairs vision •
Reduced visual acuity (near and distant object) • Glare in sunshine or with street/car lights. • Distortion of
lines. • Monocular diplopia. • Altered colours ( white objects appear yellowish) • Not associated with pain,
discharge or redness of the eye
. 22. Signs • Reduced acuity. • An abnormally dim red reflex is seen when the eye is viewed with an
ophthalmoscope. • Reduced contrast sensitivity can be measured by the ophthalmologist. • Only sever
dense cataracts causing severely impaired vision cause a white pupil. • After pupils have been dilated, slit
lamp examination shows the type of cataract.
. 23. 1. History collection 2. Visual acuity test 3. Dilated eye exam 4. Tonometry
. 24. Treatment • Glasses: Cataract alters the refractive power of the natural lens so glasses may allow good
vision to be maintained. • Surgical removal: when visual acuity can't be improved with glasses. • Surgical
techniques – Phacoemulsification method. – Extracapsular method. – Intracapsular method
. 25. Pre-op assesments • General health evaluation including blood pressure check • Assessment of
patients’ ability to co-operate with the procedure and lie reasonably flat during surgery • Instruction on eye
drop instillation • The eyes should have a normal pressure, or any pre-existing glaucoma should be
adequately controlled on medications. • An operating microscope is needed, in order to reach the lens, a
small corneal incision is made close to the limbus for the phaco-probe. • It is important to appreciate anterior
chamber depth and to keep all instruments away from the corneal endothelium in the plane of the iris.
. 26. Phacoemulsification in cataract surgery involves insertion of a tiny, hollowed tip that uses high frequency
(ultrasonic) vibrations to "break up" the eye's cloudy lens (cataract). The same tip is used to suction out the
lens .
. 27. Intra-capsular Cataract Extraction Intracapsular Cataract Extraction. From the late 1800s until the 1970s,
the technique of choice for cataract extraction was intracapsular cataract extraction (ICCE). The entire lens
(ie, nucleus, cortex, and capsule) is removed, and fine sutures close the incision. ICCE is infrequently
performed today; however, it is indicated when there is a need to remove the entire lens, such as with a
subluxated cataract (ie, partially or completely dislocated lens).
. 28. Extra-capsular Cataract Extraction (ECCE) • Extracapsular Surgery. Extracapsular cataract extraction
(ECCE) achieves the intactness of smaller incisional wounds (less trauma to the eye) and maintenance of
the posterior capsule of the lens, reducing postoperative complications, particularly aphakic retinal
detachment and cystoid macular edema.
. 29. Postoperative care after cataract surgery • Steroid drops (inflammation) • Antibiotic drops (infection) •
Avoid • Very strenuous exertion (rise the pressure in the eyeball) • Ocular trauma.
. 30. Complications of cataract surgery • Infective endophthalmitis – Rare but can cause permanent severe
reduction of vision. – Most cases within two weeks of surgery. – Typically patients present with a short history
of a reduction in their vision and a red painful eye. – This is an ophthalmic emergency. – Low grade infection
with pathogen such as Propionibacterium species can lead patients to present several weeks after initial
surgery with a refractory uveitis • Suprachoroidal haemorrhage. – Severe intraoperative bleeding can lead to
serious and permanent reduction in vision.
. 31. • Uveitis – Postoperative inflammation is more common in certain types of eyes for example in patients
with diabetes or previous ocular inflammatory disease. • Ocular perforation. • Postoperative refractive error –
Most operations aim to leave the patient emmetropic or slightly myopic, but in rare cases biometric errors can
occur or an intraocular lens of incorrect power is used. • Posterior capsular rupture and vitreous loss – If the
very delicate capsular bag is damaged during surgery or the fine ligaments (zonule) suspending the lens are
weak (for example, in pseudoexfoliation syndrome), then the vitreous gel may prolapse into the anterior
chamber. This complication may mean that an intraocular lens cannot be inserted at the time of surgery.
Patients are also at increased risk of postoperative retinal detachment.
. 32. • Retinal detachment. – This serious postoperative complication is, fortunately rare, but is more common
in myopic patients after intraoperative complications. • Cystoid macular oedema – Accumulation of fluid at
the macula postoperatively can reduce the vision in the first few weeks after successful cataract surgery. In
most cases this resolves with treatment of the post-operative inflammation. • Glaucoma – Persistently
elevated intraocular pressure may need treatment postoperatively. • Posterior capsular opacification –
Scarring of the posterior part of the capsular bag, behind the intraocular lens, occurs in up to 20% of patients.
Laser capsulotomy may be needed.