This case involves a 68-year-old patient who suffered permanent vision loss following an eye cataract surgery with lens implant. Before the surgery in question, the intraocular pressure in her eye was found to be elevated. She was started on medicated drops, but the pressure remained high at the time of surgery. She was told not to worry and that the pressure would return to normal after the procedure. No imaging or measurements were done at that time. A week after the surgery, the patient returned with a painful, red eye and complained of blurry vision. There were a series of delays in getting the patient to surgery, and she went several months without medical treatment. During the months without medical treatment, the patient suffered complete and permanent vision loss in her eye.
Question(s) For Expert Witness
- 1. How often do you perform cataract surgery with lens implant?
- 2. Have you ever managed a patient for increased intraocular pressure in the perioperative period of cataract surgery?
Expert Witness Response E-007449
I am a professor of ophthalmology at an academic medical center and I’ve been performing cataract surgeries for the last 25 years since I finished my residency. I have performed approximately 800-1000 cataract surgeries every year since then, and I perform lens implants as well. This case sounds interesting and unfortunate. Most cataract surgeries are done under normal intraocular pressure conditions because when you make the incision, the pressure can rapidly drop from high to low which can cause a number of complications. The most concerning complication would be an explosive retinal hemorrhage. The red, painful eye that the patient came back with could have been due to a secondary glaucoma, retained lens fragment, or other complication.