Although complications associated with intraocular lenses and implantation surgery occur in less than 5 percent of cases, some IOL risks do exist. Your ophthalmologist will examine your eyes and your medical history carefully to determine if you are a good IOL candidate. Ultimately, though, the decision of whether to proceed with IOL surgery after learning the costs and risks is yours.
Intraocular Lens Risks
As with any type of surgery, there are risks associated with the IOL procedures to correct the vision problems of cataracts or presbyopia. Among the most common IOL risks is minor infection. This is generally caught early and managed effectively with antibiotics. There are other IOL risks to consider, several of which are listed below.
Corneal edema (swelling) affects most IOL patients to some degree after surgery. Patients who have had previous IOL surgery, endothelial cell loss, or corneal dystrophy are most at risk for experiencing post-operative corneal edema. If the cornea was healthy prior to surgery, the condition should clear up on its own within one or two days. If the swelling persists, your ophthalmologist can provide treatment and medications.
Increased Intraocular Pressure
Intraocular pressure spikes are fairly typical following an IOL procedure. One common cause is temporarily retained viscoelastic. Your ophthalmologist uses this jelly-like substance to facilitate placement and positioning of the IOL. The thick consistency of viscoelastic can reduce outflow of the eye's aqueous fluid, causing a pressure spike that generally peaks about six hours after surgery, then subsides. Intraocular inflammation after an IOL procedure can increase risks of pressure spikes. Your ophthalmologist can provide topical medications that, in most cases, effectively treat the problem. These or similar medications can also treat pressure spikes in IOL patients who have glaucoma.
Wound leaks can lead to serious complications if they do not receive prompt, proper treatment because the interior of the eye becomes exposed to infectious agents. Low intraocular pressure following the surgery can be an indicator of a wound leak. If a leak is detected, a bandage contact lens is typically placed over the surgical site. This is usually sufficient to slow the leak adequately to allow natural healing. If the leak persists, the ophthalmologist will use surgical measures to repair the problem.
IOL decentration risks arise soon after surgery if the surgeon does not place the lens properly, or if the patient's eye has a weak zonular system for holding the lens in place. Decentration can also occur later if the patient suffers trauma, or internal forces change the dynamics of the eye's lens-containing capsule. Patients with lens decentration experience reduced vision, halos, and/or significant glare. The usual remedy is surgical repositioning of the IOL.
IOL Power Miscalculation
Surgical replacement of intraocular lenses will be necessary if the ophthalmologist misdiagnoses the power of the IOL. Cataract patients who have a history of refractive surgery are at greater risk of IOL power miscalculation.
Retinal detachment caused by IOL surgery is a risk for any patient. A retinal tear that allows ocular fluid to seep behind the retina can occur during IOL surgery. After surgery, the patient experiences flashes and "floaters" in the field of vision. Patients who experience retinal detachment are usually referred to a retinal specialist who may take immediate steps to repair the problem, or, because repair reduces the chances for full visual recovery, may wait to see if the condition improves on its own.
Understanding IOL Risks
Your ophthalmologist will perform a thorough examination of your eyes and will research your medical history to determine any factor or factors that may increase your susceptibility to IOL risks. You must do your part by being completely forthcoming about all past and present medical conditions, medications you are taking or have taken recently, and any other relevant factors.
When your ophthalmologist has a thorough understanding of your medical background and has determined the health of your eyes, he or she should carefully explain the IOL surgery and the risks you face before you undergo intraocular lens surgery. If you do not understand anything your ophthalmologist explains to you, feel free to ask questions.
If you feel that your ophthalmologist has not explained the IOL procedure, the types of IOLs that are available, and its risks adequately even after you have asked for further clarification, you may want to consult another ophthalmologist. Eye surgery is serious business, so you should feel that you are fully informed before you make the decision to proceed.
After years of rigorous testing in Europe, Asia, and in the United States by the Food and Drug Administration, intraocular lenses and implantation surgery have been proven safe and effective, with complications occurring in less than 5 percent of cases. IOL risks increase for patients with certain medical conditions and other health-related issues. Your ophthalmologist will perform a thorough examination of your eyes and will research your medical history to ensure that you are a good candidate for intraocular lenses before proceeding with the treatment.
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