Risks of Cataract Surgery

Cataract surgery has become one of the most common and well-perfected surgeries performed in North America. Its success rate is extremely high and side effects and risks extremely low. However, as with all invasive procedures, there will always be potential for problems involved.

Possible complications consist of the following:

• Endophthalmitis (an infection of the eye)
• High pressure in the eye
• Drooping eyelid
• Detachment of the retina
• Choroidal hemorrhage (bleeding that occurs behind the retina)
• Small fragments of lens which can become lodged behind the vitreous or back cavity of the eye.
• Potential for loss of sight.
• Loss of the eye

One of the two most common side effects includes an inflammatory reaction in the eye where swelling can occur and the ocular region may be tender for a few days. This is easily treated with an antibiotic or anti-inflammatory drug. The second most common side effect is known as macular edema. This is where there is fluid retention in the retina. Macular edema is more frequently seen in patients who already have a prior health problem such as diabetes. There are treatments for fluid retention as well; however, this problem usually resolves itself.

The success rate of cataracts surgery (defined as having no serious complications and resulting in improved vision) with today's advanced methods and ultra-modern equipment is at an astonishing 95%. And, the risk of becoming blind with surgery for cataracts removal is extremely low. 18 For those few patients where surgery does not result in improved vision, there is usually a different underlying ocular condition such as age related macular degeneration (ARMD) or diabetic retinopathy. 19

On the flip side of the coin, there are great advantages in quality of life and safety issues related to the successful treatment of a cataracts. Patients report improved ability to drive, read, walk, and work, practice hobbies, engage in social activities and increase their self-reliance, self-confidence and independence.

What to expect after surgery

In some cases after surgery, the surgeon may require the patient to wear an eye patch for a specified time frame. This mainly occurs with large incision cataracts surgery but is possible with other forms as well. Additionally, most patients will continue with the anti-inflammatory and antibiotic eye drops for several weeks. Patients will return to visit the surgeon for a follow-up appointment within a day or two of surgery to assess the procedure and results.

If stitches were needed after surgery they most likely will dissolve on their own requiring no additional appointment to have them removed. A majority of patients are able to return to a full schedule of activity to include physical movement, reading, driving and watching TV within a matter of hours or a few short days.

As the best vision resulting from the cataracts surgery won't usually show up until several weeks later (although the time frame varies extremely from individual to individual) the surgeon will more than likely request that the patient wait approximately four to six weeks before obtaining a new eye glass or contact lens prescription.

People who have had cataracts surgery are pleased with the results obtained and site improved vision, enhanced views, and brighter colors. Many claim they can see better after surgery than they could before the cataracts ever formed.

Will the cataracts return?

A cataracts cannot return for one simple reason. The natural lens upon which the original cataracts formed is removed during surgery. However, some clouding may take place over a few years within the posterior section of the lens capsule itself. The cloudiness is a result of cells gathering in the middle of the capsule and preventing incoming light from hitting the retina.

If this occurs there is a very simple and safe procedure which can be performed. The outpatient process for clearing up this minor problem is called YAG capsulotomy. It is painless and quick. YAG capsulotomy requires the doctor to make a small hole in the capsule with a laser beam to allow light to pass through. In the past, before YAG capsultomoy was used, a small incision had to be made and a tiny knifelike instrument inserted into the eye to cut a tiny hole into the posterior capsule. Today, however, as the hole is cut with a beam of light there are no knives or surgical incisions required. The light beam is directed to the center of the capsule, creates a small opening and clears the cloudiness.

Vision aids after surgery

After surgery is performed many patients will still require glasses or contact lenses to bring objects into completely clear view. This is normal. However, in most cases the power of glasses or contact lenses required is less than what was needed prior to surgery. Additionally, after surgery the patient no longer feels as thought they are looking through a "cloud" or "fog". It is advised to wait at least a month before obtaining new glasses or contact lenses to give the eyes time to readjust and come back to a new "normal".

Since some of the new artificial intraocular lenses (IOL) block UV radiation, in some cases it is not necessary to wear sunglasses after cataracts surgery - check with the surgeon. However, many people enjoy wearing sunglasses or feel more comfortable with them on. If this is the case, by all means, wear them.

Complicated Cataracts

In rare cases, cataracts may be more complicated to remove than the norm. An experienced and skilled surgeon however, will still be able to perform the cataracts removal surgery with few problems. A complicated cataracts may be one that is referred to as a mature brown cataracts. In this case, the cataracts has progressed to the point that it has hardened and become solid in the center. To remove this type of cataracts more force is required to break the cataracts apart. If the surgeon determines that the risk is too great for a small incision cataracts removal surgery, the large incision method will be considered instead.