![misshapen iris misshapen iris](https://www.vision-and-eye-health.com/images/Uveitis-hypopyon-PS.jpg)
Phacoemulsification of high-density cataracts, whether by torsional or longitudinal phacoemulsification mechanisms, is accompanied by significant risk for high endothelial cell loss. Endothelial cells loss is greater in diabetic patients even if under good glycemic control compared to nondiabetic individuals. 7.Įndothelial cell loss can accompany intraocular surgery, particularly that directly on the anterior segment such as cataract surgery. With the introduction of the side-port incision or the main keratome incision, the iris or the lens capsule may be cut. Most commonly, the stripping may occur at the time of the introduction of the phacoemulsifier or of the irrigation–aspiration tip, the placement of the lens implant into the eye, or during the injection of a viscous agent into the eye. Other post-operative complications: wound leak, anterior synechiae, secondary uveitis, irregular pupil, dislocated intraocular lens (IOL), secondary inflammatory membranes, nystagmus, and posterior segment complications, such as vitreous haemorrhage and retinal detachment. Įndophthalmitis: can be devastating and the child can loose the eye.(It is discussed later in this chapter.) Īmblyopia: management of amblyopia is challenging.Diminished red reflex, poor fixation and difficulty in refraction indicate the presence of posterior capsular opacity. Posterior capsule opacity: the occurrence of posterior capsule opacity is 100% in children less than 1 year of age. Progressive strabismus after cataract surgery might indicate development of amblyopia. Strabismus: esotropia is more common in congenital cataracts, whereas exotropia is more common in acquired cataracts. Aphakic glaucoma is more common than pseudophakic glaucoma in these patients. Refraction can show progressive myopic shift, which is another sign of progressive glaucoma. Intraocular pressure and the appearance of the optic discs should be checked. Ocular pain, watery eye, cloudy cornea (corneal oedema) and iris bombe are the signs that should be looked for on each visit, in particular at the first few post-operative visits. Glaucoma can manifest many years after the surgery. Glaucoma: the most commonly encountered type is pupil-block glaucoma, where the pupil is blocked either by vitreous or inflammatory membrane. Intra-operative complications: capsular tear, vitreous loss and choroidal haemorrhage. Such complications may be intra- or post-operative, some of the more common being as follows: The risk of complications due to the severe inflammatory response commonly encountered when performing surgeries on immature eyes is high. A combination of the inherent properties of an elastic eye in children and the presence of other abnormalities makes paediatric cataract surgery very challenging and a highly skilled procedure. Children with cataract often have confounding anterior segment abnormalities.