Kameen Potential Complications of Cataract Surgery
I wanted to describe a few of the potentialcomplications that can happen during Cataract Surgery. None of us like to think about complicationsof surgery, but we have to acknowledge that surgery is surgery, therefore, there are variables.What we try to do during cataract surgery, as in any procedure, is we try to reduce thenumber of variables so the potential for complications is minimized. But we still have to acknowledgethere are some. If you look at the cataract procedure, and I don't want to get too graphic,but we do want to talk about the steps. The first part of the procedure, if you pictureas I describe over and over, a cataract is being shaped like an MM candy. The firststep of the procedure is to remove the front
surface of that MM shell and then the secondstep is to actually vacuum out the cataract here. One of the risks that we run in doingcataract surgery (which is quite rare and with a decent surgeon probably happens onetime in a year, maybe every other year) is while we're working in this MM shell (asI like to describe it), the MM shell, if it's fragile (and it's extremely fragile),can actually break and when the Mif you picture now the MM shell where the back sideof it is, has a tear in it, then the implant that we want to put inside of that shell isnot supported as well, so we have to put it in the eye in a little bit different manner.Now the results are still great, but sometimes
the type of implant has to be adjusted becauseof that little rupture in the membrane. Another potential complication, which thankfully isvery rare, and that's the risk of infection. The risk of infection is estimated to be aboutone in every five to tenthousand procedures, and that's really good. We try to make itzero, but still it's surgery. The things that help us avoid infection are doing this procedurein a sterile environment (which we do) using obviously sterile equipment, doing very goodsurgical steps, surgical procedures, and then we use very good, the most powerful antibioticeye drops in the world the night before surgery and for about a week after surgery and theytend, that tends to minimize the risk of infection.
If we happen to get an infection, then thetrick is to identify it early. We can generally identify it pretty quickly and then we stepup the antibiotics and we eliminate it that way. Very rarely, I think I've had two patientsin the last decade that have, need a second procedure in order to improve the infection.So again, we try to minimize that. Other minor risks are on the surface of the eye. There'ssome irritability in the surface from where we do the little incision, but otherwise cataractprocedure is known as the safest procedure, really, of any surgery. There are millionsand millions of cataracts done every year and it's extremely safe and extremely predictable.Again, we try to reduce variables so we reduce
potential complications. Again though, we'restill human beings, and so am I, so things happen. Good surgical technique helps to getus ahead of it.
See inside your eye Part 1 Using a point light source to see floaters and cataracts
See inside your eye with that same eye. Part1. Here is a list of six techniques scientistshave described for seeing inside your eye with that same eye. The oldest technique, which is the topic ofthis tutorial, involves using a point light source to see clear shadows of floaters in your eyeand any spots you might have in the lens of your eye. In this tutorial I will demonstratea number of ways to do this while reviewing the history and explaining some of the science.I will also show numerous examples of what you might see in your own eyes.
The other techniques allow you to see bloodmoving in capillaries on the retina, shadows of the blood vessels on the retina, nerveactivity on the retina, and the back of the eye. I hope to cover these other techniquesin future tutorials. But let's get back to the topic of this tutorial,the first and oldest technique for seeing inside your own eye with that same eye, startingwith a little science history. The German astronomer Johannes Kepler publisheda book on optics in 1604. in which he stated that our eyes function by focusing an imageonto the back of the eye. The physicist and astronomer Christoph Scheiner proved Keplerwas right by removing most of the tissue from
the back of actual eyes and looking at thefocused images. Then, in 1674, the French mathematician ClaudeFran ois Dechales described how a near sighted person or someone holding a magnifying lensin front of their eye can see the shadows of defects in the eye in the unfocused imageof a distant light source. It was later discovered that looking at a brightly lit surface througha pinhole in a card held close to the eye served the same purpose, as well as otherlens arrangements and looking closely at the reflection of a distant light in a tiny dropof mercury on black felt. Let me explain how these various methods workand also demonstrate these and some other
variations. Light rays from a sufficiently distant andsmall source arrive at the eye almost parallel. The light can be a candle like Dechales used,or something like a AAA mini Maglite(R) in candle mode which I prefer to use. The corneaand lens of the eye refract this light to focus it to a point on the retina. But ina nearsighted person this light will be focused to a point in front of the retina then itwill spread out on the retina. It will appear as a disk because its shape is determinedby the shape of the opening in the iris, which is round in humans. Holding a magnifying lensin front of your eye will do the same thing.
Not only does the border of the iris casta shadow, but so does whatever might be in the path of the light, like a dark spot inthe lens of the eye. You can also use a concave lens, perhaps onesalvaged from the viewfinder of a junk camera, to create an unfocussed image of a distantlight on your retina. Or you can cancel out the focusing effect of the cornea by fillinga swim goggle with saline solution. Finally, you can use a tiny, shiny, convex surface,like a small drop of mercury on black felt or the tines of a fork held to reflect light.What you are actually doing is creating a virtual image of the distant light. This imageis functionally the same as a tiny light source
held too close to your eye for you to focuson. You can also create a real image using a magnifying lens. However, using a mirroror lens has the disadvantage that you will see any imperfections in the mirror or lensas shadows, along with the shadows of things on or in your eye. The best thing to do is to simply create apoint source of light that can be held close to your eye. One of the easiest ways to dothis is to crumple up some aluminum foil, then flatten it out. Put this over a flashlightand you will notice numerous tiny holes. Put a piece of matte finish cellophane tape oversome of the holes to diffuse the light, then