Risks & Side Effects of Cataract Surgery


Before going ahead with cataract surgery, you should be aware of the side effects following the procedure.  These include:

  • Uncomfortable itchy or sticky eye, immediately following surgery and lasting for a few days.
  • A loss of vision for a few days following surgery.
  • Aching eye for a few days following surgery.
  • Eye bruising, which will heal normally.

The most common complications of cataract surgery are:

  • Swelling of the cornea (oedema) or the retina.  Cystoid Macular Oedema causes blurred central vision for up to six weeks after surgery but usually resolves itself within three months.  Anti-inflammatory drops or medication can be prescribed, to speed up recovery.
  • Increased intraocular pressure.
  • Ptosis, which is droopy eyelid. See Ptosis.
  • Uveitis, which is the inflammation of the layer of eye tissue, which includes the iris. See Uveitis. 

The risks involved in cataract surgery should be discussed with your eye surgeon.  All risks should be clearly explained and all your questions should be answered satisfactorily before proceeding with the procedure.  Cataract surgery is very common and risks are minimal and a successful result is achieved in virtually all cases.  Potential complications range from minor inflammation to severe vision loss.  The risk of vision loss is very rare and may be a result of infection or bleeding.  As with any surgery, there is a risk of infection, which can usually be managed with oral or eye drop antibiotics.  If the infection is external, it may develop into endophthalmitis.  Haemorrhage or bleeding may occur during or after the surgery and some people react to anaesthetics.  These are again risks common to any surgical procedure.

Cataract Surgery Specific Risks:


Posterior Capsular Opacification (PCO)

This is a thickened and cloudy lens casing following cataract surgery, which may not be noticeable for some years.  It eventually causes vision to become unclear like cataract but can be treated quite easily using laser surgery.  Although, Posterior Capsule Opacity is not a cataract, it is often referred to as a ‘secondary cataract.’ SeePosterior Capsular Opacification (PCO).

Tearing of Posterior Lens Capsule

This can lead to reduced vision.  This is a clear bag, which surrounds the lens.  In cataract surgery the hole, which is created in the capsule to remove the cloudy lens material, can become torn.  An IOL can still be placed on top of the remaining capsule but if some of the lens falls into the vitreous jelly, further surgery is most likely required.

Lens Displacement

Some of the broken lens may be displaced into the back of the eye.  This can only be removed by an operation.

New Lens Displacement

Further surgery will be required if the new lens becomes displaced.  It may be either moved or replaced.  The edge of the lens may be visible or you may experience double vision or visual acuity may be affected.  Displacement may be caused by the capsular bag (where the IOL is placed) becoming ruptured or breaking, as it is very thin and delicate.  This leads to zonular dialysis.  Another cause for displacement may be due to the ‘arms’ of the new lens being positioned improperly.  Further surgery or a new lens may be placed, in these circumstances. 

Increased Intraocular Pressure (IOP)

Glaucoma may be treated with eye drops, laser procedure or medication. See Increased Intraocular Pressure (IOP).

Vision

Reduced vision or blindness possibly due to damaged retina (Retinal Detachment), which may not be noticed for years, or endophthalmitis.  The latter causes inflammation or infection and has been linked to poor immune systems for example, those with diabetes.

Cystoid Macular Oedema (CME)

luid may collect in the layers of the macula.  If this happens, vision becomes blurred and there is distortion of central vision. See Cystoid Macular Oedema (CME).

Choroidal Haemorrhage

This is a very rare condition, where there is bleeding within the layer of blood vessels that nourish the retina. Localised bleeding may resolve itself but in severe circumstances there may be some loss of vision.

Endophthalmitis

This eye infection is extremely uncommon but potentially the most dangerous.  Symptoms include pain, redness of the eye and a loss of vision within a week of surgery. See Endophthalmitis.

IOL Errors

Generally the new lens is designed to provide good distance vision without glasses/contact lenses and improved near vision.  Errors can occur in the strength of the lens in which case you may be more long or short sighted.  In rare cases, the lens maybe replaced with one with a more suitable strength.

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