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Cataract Surgery Complication: Common & Uncommon Complications

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It’s estimated that over 98% of cataract surgeries are highly successful and involve no serious complications during or after the procedure. 

As with any surgery, some side effects are to be expected. Normal side effects after cataract surgery may include redness, swelling, or discomfort around the eye. Floaters, blurred vision, and sensitivity to light may also occur. 

Most people who undergo cataract surgery won’t experience any major complications or problems. 

Uncommon but serious complications from cataract surgery include an infection called endophthalmitis, dislocation of the intraocular lens, and retinal detachment. Inflammation of the eye, droopy eyes, and posterior capsule opacification (also called secondary cataracts) may occur in rare cases.

The presence of underlying health issues or other eye problems may increase the risk of serious complications. 

Cataract Surgery Complications

Cataract surgery is a very simple and effective procedure and is often the best choice for regaining vision and quality of life for someone who has a cataract. Over 4 million cataract surgeries are completed each year in the U.S. According to the American Academy of Ophthalmology (AAO), over 99.5 percent are successful and result in no serious problems. 

Today’s surgical and dental advancements have only made cataract surgery safer. Tools like lasers and digital diagnostic instruments allow for more effective and precise treatment. 

Still, there are rare but possible serious complications that can develop during or after cataract surgery. These include the following:

Light Sensitivity 

Some light sensitivity (photophobia) is normal after cataract surgery, but ongoing or severe light sensitivity can be indicative of eye swelling or inflammation. If a patient is experiencing light sensitivity longer than a few days after surgery, they should seek medical care.

Eye Inflammation & Swelling of the Cornea

Mild swelling is normal immediately after surgery, but swelling that is severe or lasts for more than a few days after surgery may need additional treatment, such as anti-inflammatory medications or eye drops.

Increased Pressure in the Eyeball (Ocular Hypertension) 

Eye surgery, including cataract surgery, can increase pressure in the eye. This can affect vision and eye health, and it can even cause glaucoma. Ocular hypertension is usually treated with medication, eye injections, or eye drops. 

Posterior Capsule Opacity

During cataract surgery, the cloudy natural lens of the eye is removed and replaced with a plastic artificial lens, called an intraocular lens (IOC). Part of the lens tissue, the capsule, is left in place during and after surgery to help keep the IOC in place. This part of the capsule can become foggy and cause vision problems, which is a condition known as posterior capsule opacity (PCO). 

This is sometimes called secondary cataracts or after-cataracts, but it is not actually a cataract. In fact, this issue is affecting a different part of the eye than the part that was treated during the surgery. Cataracts cannot develop on the artificial lens. 

Posterior capsule opacity occurs in about 20 percent of people who have cataract surgery. It can develop anywhere from weeks to even years after the cataract surgery. It can cause vision loss if left untreated.

PCO is treated with YAG laser capsulotomy, a quick and painless outpatient procedure. PCO cannot develop a second time, so the procedure needs to be done only once.

Intraocular Lens Dislocation

Intraocular lens dislocation occurs when the artificial lens that was transplanted during cataract surgery becomes dislodged from the “capsular bag” in which it was placed. This can cause a patient to experience blurry vision or double vision. 

Intraocular lens discoloration is extremely rare, affecting approximately 0.1 percent of patients. It’s usually treated with surgery that replaces the lens or moves it back into place.  

Detached Retina

A detached retina can occur months, and even years, after cataract surgery. This happens when the sensitive tissue at the back of the eyes moves (the retina) from its normal position. This separates the cells in the retina from the layer of blood vessels that supply oxygen and needed nutrients to the eye. 

The longer the retina is detached, the greater the risk of complete vision loss. A detached retina requires immediate care and surgery. 

Excessive Bleeding

Mild bleeding immediately after surgery isn’t abnormal and may be a common side effect. However, more serious or ongoing bleeding is indicative of a serious medical emergency. The bleeding may be a result of leaking blood vessels. Immediate care is needed to prevent vision loss. 

Droopy Eyelids

Droopy eyes (called ptosis) are common after surgery and usually disappear within a few weeks, if not sooner. Ongoing or severe ptosis may need to be treated with surgery. 

Uncommon & Serious Complications

Serious complications from cataract surgery are very rare. If vision loss does occur, it is likely the result of infection or bleeding within the eye.

It is possible that in a small number of patients, vision does not improve after their cataract surgery. If this is the case, it is likely that they have underlying eye disorders, such as diabetic retinopathy and age-related macular degeneration. The presence of these conditions will likely require a combination of further treatments, such as medications, surgery, and vision aids.
However, for an overwhelming number of the people receiving cataract surgery, the procedure is painless, quick, and without significant problems, side effects, or complications.

References

  1. Cataract Surgery Complication Rates. (August 2008). Ophthalmology.
  2. Posterior Capsule Opacification. (March 2015). Kellogg Eye Center.
  3. Intraocular Lens Dislocation. (2016). American Society of Retina Specialists.
  4. The Risks and Benefits of Cataract Surgery. (October 2002). Digital Journal of Ophthalmology.
  5. Extreme Photophobia After Cataract Surgery. (March 2014). American Academy of Ophthalmologists.
  6. Cataract and Diabetic Retinopathy. (September 2011). Community Eye Health.
  7. Possible Side Effects and Complications after Cataract Surgery. (2021). AARP.
  8. What Are the Risks of Cataract Surgery? VisionAware.org.
  9. Posterior Capsule Opacification. University of Michigan Health System.
  10. Retinal Detachment. (December 2022). StatPearls.

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