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Vision Today Review Cataract surgery has come a long way over the
years and the surgical results are dramatically better then in the
past. However, there are still potential complications and careful
presurgical evaluations can often predict after surgery
complications. One such potential problem is corneal edema (swelling
of the cornea). With the development of Phacoemulsification which
involves vibrations that break apart the cataractous lens, the
likelihood of corneal swelling is much greater. In the hands of an
experienced cataract surgeon, this side effect should be minimized,
but there are certain ocular conditions that may still results in
substantial post surgical corneal edema.
A
very dense cataract will require a longer and more intense time
period to break apart the lens; thus increasing the intraocular
vibrations. This will in turn result in more swelling within the eye.
Likewise a shallow anterior chamber (the area between the iris and
the cornea) will result in more post surgical swelling. This
decreased distance permits more of the shock waves from the phaco
instrument to reach the endothelial layer (back layer) of the cornea
resulting in more swelling. All pre-existing corneal disease will
weaken the cornea and therefore result in more post surgical edema;
the worse the disorder, the more the swelling. Finally, viscoelastic
fluid from the surgery may clog up the drainage areas thus resulting
in high post surgical intraocular pressures. This in turn will cause
the cornea to become swollen.
In
short, proper presurgical evaluations can often predict post surgical
corneal swelling. While this should not be a contraindication for the
surgery; expecting this side affect will make the follow up care
better and permit more complete patient instructions. It will also
allow the patient to have more accurate expectations post surgically.
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