Corneal Complications of Cataract Surgery

The intraoperative and postoperative complications of cataract surgery that affect the cornea vary in etiology and severity. Principal complications include epithelial disruption, infections, sterile corneal ulceration, stromal melt, mechanical or toxic injury of the endothelium, vitreous touch, stripped Descemet's membrane, and epithelial and fibrous downgrowth. Meticulous cataract surgery with careful attention to protecting the cornea can prevent most serious corneal complications. Certain clinical situations warrant special note; patients with rheumatoid arthritis and dry eyes require extra lubrication to the epithelium to prevent disruption during surgery; patients with low endothelial cell counts benefit from the least possible surgical trauma to minimize cell loss; surgical clean-up of vitreous from the anterior segment remains an important principle; clinically significant Descemet's membrane tears or areas of stripping should be repaired at the time of cataract surgery. The clinical judgment and skills of the cataract surgeon should be equal to the type of cataract operation performed.