{"id":200,"date":"2016-08-26T03:48:58","date_gmt":"2016-08-26T03:48:58","guid":{"rendered":"http:\/\/www.cataractcourse.com\/?page_id=200"},"modified":"2017-02-01T01:31:46","modified_gmt":"2017-02-01T01:31:46","slug":"complicated-surgery","status":"publish","type":"page","link":"http:\/\/cataractcourse.com\/surgery\/complicated-surgery\/","title":{"rendered":"Complicated surgery"},"content":{"rendered":"<p>Many factors affect the risk of complications in cataract surgery. Here are a few:<\/p>\n<ul>\n<li>Small pupil size<\/li>\n<li>Inability to lay still for 15-20 minutes (restless leg syndrome, obstructive sleep apnea, CHF, COPD, back pain, and others)<\/li>\n<li>Zonular laxity (increases risk of IOL dislocation)<\/li>\n<\/ul>\n<figure id=\"attachment_582\" aria-describedby=\"caption-attachment-582\" style=\"width: 214px\" class=\"wp-caption alignright\"><img class=\"wp-image-582\" src=\"http:\/\/cataractcourse.com\/wp-content\/uploads\/2016\/08\/IOL-dislocation-AA0_54577-1-e1483582911490-300x296.jpg\" width=\"214\" height=\"211\" srcset=\"http:\/\/cataractcourse.com\/wp-content\/uploads\/2016\/08\/IOL-dislocation-AA0_54577-1-e1483582911490-300x296.jpg 300w, http:\/\/cataractcourse.com\/wp-content\/uploads\/2016\/08\/IOL-dislocation-AA0_54577-1-e1483582911490-768x757.jpg 768w, http:\/\/cataractcourse.com\/wp-content\/uploads\/2016\/08\/IOL-dislocation-AA0_54577-1-e1483582911490-1024x1009.jpg 1024w, http:\/\/cataractcourse.com\/wp-content\/uploads\/2016\/08\/IOL-dislocation-AA0_54577-1-e1483582911490-100x100.jpg 100w, http:\/\/cataractcourse.com\/wp-content\/uploads\/2016\/08\/IOL-dislocation-AA0_54577-1-e1483582911490.jpg 1102w\" sizes=\"(max-width: 214px) 100vw, 214px\" \/><figcaption id=\"caption-attachment-582\" class=\"wp-caption-text\">IOL dislocation<\/figcaption><\/figure>\n<ul>\n<li>Small anterior chamber decreased workspace during surgery)<\/li>\n<li>Floppy iris syndrome (IFIS). Stopping alpha-1 antagonist therapy before surgery is not beneficial, but awareness of exposure and use of an iris retractor\u00a0or pupillary (Malyugin) ring intraoperatively can help avoid complications. (See videos of <a href=\"https:\/\/www.youtube.com\/watch?v=rRQkJP6wLSk\" target=\"_blank\">iris retractors<\/a> and <a href=\"https:\/\/www.youtube.com\/watch?v=y6s08_SLO-8\" target=\"_blank\">Malyugin rings<\/a> in action).<\/li>\n<li>Pseudoexfoliation syndrome (PXF) can lead to poor pupillary dilation, zonular instability leading to mobile or subluxed lenses that are difficult to remove, and corneal endothelial dysfunction that may increase corneal edema after cataract surgery.\n<ul>\n<li>PXF is an age-related systemic microfibrillopathy that leads to gradual deposition of fibrillary particles from the lens and iris pigment epithelium onto the anterior lens capsule, ciliary body, zonules, trabecular meshwork, corneal endothelium, and iris. This also increases the risk of glaucoma. <a href=\"http:\/\/www.hopkinsmedicine.org\/wilmer\/services\/glaucoma_center_excellence\/book\/ch06s02.html\" target=\"_blank\">Gonioscopy<\/a> can be used to detect pigmentation in the angle in this disease. Malyugin rings, iris retractors, and capsular tension devices for zonular support can be used during surgery to help prevent complications.\n<p><figure id=\"attachment_580\" aria-describedby=\"caption-attachment-580\" style=\"width: 293px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-580\" src=\"http:\/\/cataractcourse.com\/wp-content\/uploads\/2016\/08\/Pseudoexfoliation-syndrome-AA0_55297.jpg\" width=\"293\" height=\"191\" srcset=\"http:\/\/cataractcourse.com\/wp-content\/uploads\/2016\/08\/Pseudoexfoliation-syndrome-AA0_55297.jpg 1025w, http:\/\/cataractcourse.com\/wp-content\/uploads\/2016\/08\/Pseudoexfoliation-syndrome-AA0_55297-300x196.jpg 300w, http:\/\/cataractcourse.com\/wp-content\/uploads\/2016\/08\/Pseudoexfoliation-syndrome-AA0_55297-768x501.jpg 768w, http:\/\/cataractcourse.com\/wp-content\/uploads\/2016\/08\/Pseudoexfoliation-syndrome-AA0_55297-1024x667.jpg 1024w\" sizes=\"(max-width: 293px) 100vw, 293px\" \/><figcaption id=\"caption-attachment-580\" class=\"wp-caption-text\">Pseudoexfoliation syndrome<\/figcaption><\/figure><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<div id=\"textbox\">\n<p class=\"alignleft\"><a href=\"http:\/\/cataractcourse.com\/surgery\/presurgical-screening\/\">Previous<\/a><\/p>\n<p class=\"alignright\"><a href=\"http:\/\/cataractcourse.com\/surgery\/surgical-modalities\/\">Next<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Many factors affect the risk of complications in cataract surgery. Here are a few: Small pupil size Inability to lay still for 15-20 minutes (restless leg syndrome, obstructive sleep apnea, CHF, COPD, back pain, and others) Zonular laxity (increases risk of IOL dislocation) Small anterior chamber decreased workspace during surgery) Floppy iris syndrome (IFIS). Stopping alpha-1 antagonist therapy before surgery is not beneficial, but awareness of exposure and use of an iris retractor\u00a0or pupillary (Malyugin) ring intraoperatively can help avoid&#8230;<\/p>\n<p class=\"read-more\"><a class=\"btn btn-default\" href=\"http:\/\/cataractcourse.com\/surgery\/complicated-surgery\/\"> Read More<span class=\"screen-reader-text\">  Read More<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":183,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v19.11 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Complicated surgery - The Cataract Course<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/cataractcourse.com\/surgery\/complicated-surgery\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Complicated surgery - The Cataract Course\" \/>\n<meta property=\"og:description\" content=\"Many factors affect the risk of complications in cataract surgery. Here are a few: Small pupil size Inability to lay still for 15-20 minutes (restless leg syndrome, obstructive sleep apnea, CHF, COPD, back pain, and others) Zonular laxity (increases risk of IOL dislocation) Small anterior chamber decreased workspace during surgery) Floppy iris syndrome (IFIS). Stopping alpha-1 antagonist therapy before surgery is not beneficial, but awareness of exposure and use of an iris retractor\u00a0or pupillary (Malyugin) ring intraoperatively can help avoid... 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Here are a few: Small pupil size Inability to lay still for 15-20 minutes (restless leg syndrome, obstructive sleep apnea, CHF, COPD, back pain, and others) Zonular laxity (increases risk of IOL dislocation) Small anterior chamber decreased workspace during surgery) Floppy iris syndrome (IFIS). Stopping alpha-1 antagonist therapy before surgery is not beneficial, but awareness of exposure and use of an iris retractor\u00a0or pupillary (Malyugin) ring intraoperatively can help avoid... 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