An update of recommendations for follow-up care following unsuccessful cataract surgery

ABSTRACT

Introduction

Unsuccessful cataract surgery includes complicated cataract surgery with intraoperative or postoperative complications hampering the visual outcome. Uneventful cataract surgery with suboptimal visual outcomes due to residual refractive errors may be termed as a functionally unsuccessful surgery. In addition, dissatisfied patients after uneventful surgery and optimal visual acuity also constitute a type of unsuccessful cataract surgery.

Areas covered

We discuss various causes of unsuccessful cataract surgery with emphasis on their management and follow-up. A comprehensive pubmed search was performed using ‘phacoemulsification’, ‘complications’, ‘post-phacoemulsification’, ‘cataract surgery complications’, and ‘postoperative assessment’ as keywords.

Expert opinion

Patient counseling and reassurance is the key to providing optimal follow-up care in complicated cases. Early detection and timely intervention can help in preventing further worsening of complications and help achieve optimal outcomes. Regular follow-up, proper management of complications, and reassurance to the patient are required in all cases of unsuccessful surgery.

KEYWORDS:

• Phacoemulsification
• complications
• post-phacoemulsification
• cataract surgery complication
• postoperative assessment

Article highlights

• Unsuccessful cataract surgery includes anatomically unsuccessful surgery with intraoperative or postoperative complications, functionally unsuccessful surgery with uneventful cataract surgery and suboptimal visual outcomes, and patient dissatisfaction after uneventful surgery and optimal visual acuity.

• Timely detection and management are essential to achieve optimal outcomes in cases with intraoperative and postoperative complications.

• Residual refractive error leads to functionally unsuccessful surgery; surgical management options include corneal ablation, piggyback IOL, IOL exchange or toric IOL rotation.

• Patient dissatisfaction after uneventful surgery may be caused by dry eye disease or dysphotopsia. The quality of life and visual quality is suboptimal even in the presence of good visual acuity.

• Patient counseling and reassurance is the cornerstone of management after an unsuccessful surgery

• Regular follow-up visits are essential to monitor response to treatment and detect any secondary complications.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.