Intraoperative Complications of Cataract Surgery

Die Kataraktchirurgie ist in der entwickelten Welt ein sehr haufig und erfolgreich durchgefuhrtes Verfahren. Die Indikation fur die Operation hat sich einerseits zu gesunderen Patienten, die eine Brillenfreiheit wunschen, andererseits zu komplexeren Fallen verschoben. Wie sind die Patienten aufzuklaren? Welche Komplikationen konnen intraoperativ auftreten und welche Optionen zur Behandlung dieser Komplikationen gibt es? Abstract Cataract surgery is frequently and successfully performed in the developed world. The indications for the operation have shifted on one hand towards healthier patients seeking freedom from glasses and on the other hand towards more complex cases. How should the patient be informed? What complications can occur intraoperatively, and what treatment options are available for these complications? This article offers a focus on conditions such as zonulopathy and pseudoexfoliation that can pose challenges to cataract surgery. It discusses the use of specialized tools such as capsular tension rings and capsular hooks and precise maneuvers to minimize stress on weakened zonules in order to ensure in-the-bag fixation of the IOL. Furthermore, the article addresses appropriate actions towards intraoperative complications such as anterior or posterior capsule ruptures and loss of nuclear fragments into the vitreous cavity. Exploring innovative advancements, this article presents the latest alternatives for intracapsular lens fixation, such as sutureless scleral fixation and emerging lens designs in cases where there is insufficient capsular support. Ultimately, the primary objective remains delivering optimal outcomes even for complex cases, and minimizing post-surgical issues. Numerous tools and techniques are available.