Taking a Closer Look at Opthalmic & Laser Eye Surgery



Ophthalmic surgery is one of the most delicate types of surgery anyone can undergo. Whether it be cataract surgery, retinal surgery for diabetes or LASIK eye surgery, which is corrective surgery to restore a person’s vision. The surgery involved requires very accurate movement on the part of the doctor and mistakes can easily happen which in many cases will be classed as medical malpractice.

Anesthetic Complications

There can be complications because of the anesthesia used to numb the eye for surgery. Complications can result in minor stinging or can result in devastating loss of vision. There can be allergic reactions to the anesthetic resulting in clouding of the cornea, swelling of the eye and extreme itching and pain. If a patient is known to have local anesthetic allergies, the doctor needs to be aware of the cross-reactivity of local anesthetic agents.

Severe Systemic Reaction

The anesthetic can leak into the intracerebral space through leakage of the anesthetic around the optic nerve. This can lead to a severe systemic reaction that includes seizures, coma, respiratory distress and cardiac arrest/death. This is an unusual complication and is believed to be due to using too much anesthetic in a patient who is allergic to the local anesthetic. There can be systemic reactions to the epinephrine used to make the anesthetic work better. The epinephrine can be injected into a vein or artery so that it causes the heart to race and possible heart attack in patients at risk.

Subconjunctival Edema

Doctors can cause a situation called chemosis, which is also called subconjunctival edema. This is swelling of the subconjunctival tissues due to an allergic reaction to the anesthetic. Bruising can occur around the eye if the injected anesthetic is injected through an artery or vein, leading to local bleeding.

Retrobulbar Hemorrhage

A more serious complication is called a retrobulbar hemorrhage. This results from improper eye blocking anesthesia. It occurs in up to 1.7 percent of patients, usually in the elderly and usually in those on some type of blood thinner like Coumadin or aspirin. The eyelids become tight and the eyes bulge from bleeding behind the bulb of the eye itself. The pressure of the eye becomes increased and the vision can become permanently damaged.

Accidental Perforation

The doctor can accidentally perforate the bulb of the eye itself. This is an uncommon complication but can introduce bacteria into the humor of the eye. Globes of the eye that are greater than 26 mm in length have a higher risk for puncturing the globe when introducing an artificial lens in cataract surgery. Near-sighted people are at a particularly high risk. It can also happen during the insertion of a needle during the giving of anesthetic to the patient. It can damage the vision to the eye if it is done in the wrong place and affects the visual part of the eye. Damage of this nature may be due to negligence and a medical malpractice lawyer will be able to give advice on the potential for a legal personal injury compensation claim.

Optic Nerve Damage

There can be direct damage to the optic nerve, the optic nerve sheath or the central retinal artery. This can result in a great loss of vision and happens when the doctor does anesthesia into the wrong part of the back of the eye. Knowledge of eye anatomy is essential to reducing the risk of this complication.

Laser Eye Surgery

The success of the procedure depends on an accurate examination of the eye as well as on accurately programming the laser computer. Errors in any part of this can result in poor vision or possibly infection of the eye as a result of the laser surgery. It is a delicate procedure that requires careful measurements of the lens for it to be successful. Failure in any one of the steps necessary to make sure the eye will be improved by the procedure can result in worsened vision.

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