Cataract surgery is a common medical procedure that normally results in improved vision. However, a patient can also have severe complications during surgery that can result in impaired vision and even blindness. Many times a poor outcome is caused by medical malpractice in managing the complications that occur during surgery.
One complication of cataract surgery is a rupture of the posterior capsule or capsular bag (PC). The PC is a very thin membrane that houses the natural lens of the eye, which is also called the crystalline lens. The PC is also the eye structure that surgeons use to implant a new artificial lens, called an intraocular lens.
Possible results of a PC rupture
When cataract surgery is performed, the cataract, which is a clouding of the natural lens of the eye, must be removed and a new artificial lens implanted. In order to do this, doctors must break the front of the PC and remove the crystalline lens. Some physicians liken this process to removing the pulp of a grape while leaving the skin intact. Once the pulp is removed, all that is left is the grape skin, which is then used to support the new artificial lens and has a bag-type appearance. If the skin of the grape is broken during surgery, a few things can happen that can lead to blindness or loss of vision.
First, the natural lens fragments can migrate to the back of the eye. They must ordinarily be removed during a subsequent surgery by a different type of eye surgeon, called a vitreoretinal surgeon. Also, the artificial lens can migrate to a place in the eye where is should not be. If this happens, it must be removed, usual by a vitreoretinal surgeon. Third, the vitreous material, which is a jelly-like substance that is supposed to be in the back of the eye, can move forward into the front portion of the eye. Sometimes the cataract surgeon can remove that substance, but sometimes a vitreoretinal specialist must remove it. These complications can cause a lot of problems for cataract patients, including blindness.
A ruptured PC is a recognized risk of cataract surgery. This rarely happens, however, and it is almost always attributable to poor surgical technique from an inexperienced surgeon. Before undergoing cataract surgery, you should ask your surgeon about how frequently this complication occurs for him or her and how the surgeon plans to avoid it.
Patients at a higher risk
Male patients on Flomax are at increased risk for PC rupture. Precautions can be taken to avoid the problem, including discontinuing the Flomax for some time. Another preventative measure is the use of a medication called atropine during surgery, which helps to dilate the pupil. Flomax can make the pupil constrict during surgery, which can reduce the surgeon’s ability to see the surgical site. Hence, it is important to keep the pupil dilated so that the surgeon can see well and avoid rupturing the PC. Another precautionary step is to use iris retractors, which also keep the pupil from dilating.
Proper management of complications is key
A patient who experiences a PC rupture can still have a good prognosis following cataract surgery, but the problem must be managed properly. Sometimes eye surgeons do not managed the complication well, as they must, and permeant visual deficits can result.
Most medical malpractice actions involving a ruptured PC center around whether the eye surgeon managed the problem in accordance with the safety rules, or standards of care, that doctors establish for themselves. Because the problem is relatively rare, eye surgeons are not always well educated about managing this complication—even though they should be. Indeed, all cataract surgeons must plan to avoid a PC rupture, but if one does happen, they must manage it properly. If your cataract surgeon has not managed a PC rupture or any other aspect of your surgery properly and you suffer decreased vision or blindness, the surgeon may be responsible for your injuries.
Who can help?
If you've suffered vision loss or blindness following cataract surgery, you should seek help from a competent medical malpractice lawyer experienced in this type of medical error. At Lipsitz Green Scime Cambria, based in Buffalo, New York, we have experienced medical malpractice trial lawyers who know the best way to evaluate and pursue your case. We have handled many cases involving ruptures of the PC and have been able to resolve those cases for substantial monetary awards. We are respected by experienced medical malpractice defense attorneys who know that we will spare no expense to retain leading medical experts from well-respected medical practices and universities to help ensure you get justice and full compensation for your injuries. Please give us a call.
This article does not purport to give legal advice and is for informational purposes only.