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Some retinal complications can be managed before lens surgery
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LOS ANGELES — The most common retinal complications after modern lens surgery can be treated, managed or even avoided with the correct preoperative examination, according to a presenter here.
“This is a plea to look at these patients with OCT. It’s absolutely crucial,” Steve Charles, MD, said at Refractive Subspecialty Day preceding the American Society of Cataract and Refractive Surgery meeting.
Steve Charles
The most frequent retinal complications after modern lens surgery are cystoid macular edema, retinal detachment, endophthalmitis and suprachoroidal hemorrhage, all of which are directly caused by the surgery. There are several intraoperative and postoperative measures a surgeon can take to reduce the rates of these complications, including using a vitreous cutter instead of a cellulose sponge during vitrectomy to avoid retinal detachment, he said.
However, some issues can be detected preoperatively if OCT is used, such as subtle age-related macular degeneration and mild retinal vein occlusion, Charles noted.
“It’s stunning to me how often patients come into my office, as a retinal specialist, that have had cataract surgery and nobody knew they had a whole variety of macular disorders. The interesting part about that is they’re invisible,” he said.
Anti-VEGF injections vastly improve outcomes for AMD, RVO and diabetic macular edema, so the injection schedule should never be interrupted for cataract surgery. Injections can be performed a few days before surgery or after 1 week, he said. – by Robert Linnehan
Reference:
Charles S. What are the short and long term risks of retinal complications? Presented at: American Society of Cataract and Refractive Surgery annual meeting; May 5-9, 2017; Los Angeles.
Disclosure: Charles reports he receives a royalty or other financial gain, a retainer, ad hoc fees or other consulting income from and his travel expenses have been reimbursed, paid in full or subsidized by Alcon Laboratories.