Earlier this year,
an American
Academy of
Ophthalmology Task
Force, of which I am
a member, issued
definitions for 11
post-operative
adverse events asso-
ciated with premium
intraocular lenses
(osmag.net/KqM7Df) intended to reduce spectacle dependence —
namely, chronic anterior uveitis; clinically significant cystoid macular
edema; corneal edema; endophthalmitis; mechanical pupillary block;
increased intraocular pressure; rhegmatogenous retinal detachment;
toxic anterior segment syndrome (TASS); and 3 secondary IOL inter-
ventions (exchange, removal and repositioning).
Although some of these adverse events may occur in small numbers
for reasons that are beyond a surgeon's control, the surgeon plays a
key role in managing, if not preventing, many of these complications.
For example, consider 2 of the most serious inflammation-related
adverse events:
• Endophthalmitis. This rare but potentially devastating infectious
intraocular inflammation occurs in fewer than 1 in 1,000 cases.
Barring a significant manufacturing glitch from a key supplier — as a
reminder, rely only on accredited 503B compounders and reputable
manufacturers that can provide proof of sterilization — the majority
of endophthalmitis cases originate from ocular flora native to the
patient's eyelashes and lid margins.
8 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U N E 2 0 1 7
• UNAVOIDABLE Some adverse events associated with cataract surgery may occur for reasons beyond a
surgeon's control.
