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Cataract Surgery Risks: What Are They? (+ the Rates)

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Last Updated

For the vast majority of patients, cataract surgery will cause no complications. Cataract surgery is widely considered a low-risk surgery. Though complications are possible, they are rare. 

Most risks are linked to patients with pre-existing visual disorders or other health concerns that might complicate the recovery process. 

In rare cases, a condition called endophthalmitis can occur after cataract surgery. Retinal detachment is another uncommon complication. Other possible complications include bleeding, inflammation, and dislocation of the artificial intraocular lens.

Cataract surgery remains a very safe remedy for cataracts, especially with today’s modern dental and surgical advancements that include smart diagnostic tools and laser-assisted surgery. 

The Safety of Cataract Surgery

Cataract surgery is generally a highly safe and effective procedure. Harvard Medical School describes the treatment as “low-risk, fast, and effective.” Approximately 98 percent of individuals experience no serious or ongoing issues after completing the surgery. 

Even though the procedure is almost always safe, as with any surgery, it’s important for patients to be aware of the potential risks. 

If any complications do occur with cataract surgery, they are usually corrected with further treatment or, in rare cases, additional surgery. 

Normal Side Effects of Cataract Surgery

Surgery for cataracts is a low-risk procedure, but it’s still surgery, and some side effects are to be expected. The following mild side effects are normal and will usually resolve themselves within one to two days:

  • Swelling around the eye or in the eye
  • Eye dryness, itchiness, or irritation
  • Light sensitivity
  • Visual effects, such as blurred vision or seeing halos or floaters
  • Grogginess or dizziness from anesthesia 
  • Redness around the white of the eye
  • Mild bleeding

Possible Complications From Cataract Surgery

Uncommon, more serious complications from cataract surgery can occur in rare cases. Patients who have other eye conditions or serious medical conditions have a higher risk of developing problems after their cataract surgery. It is vital that they inform their doctor of these potential complications.

Some possible complications after cataract surgery include the following:

Bleeding

While mild bleeding during or immediately after the surgery is not uncommon or dangerous, more serious bleeding could be a sign of a serious leak of the retinal blood vessels. This requires emergency medical care as it could result in vision loss, especially if the blood is leaking into the area between the cornea and iris. 

While eye drops may be used to treat the condition effectively in many cases, some individuals may need steroids and/or surgery. 

Infection

Endophthalmitis is a serious infection of the inner eye that can develop in the first week after surgery. It is typically the result of a bacterial infection. It requires immediate medical care and is usually treated with antibiotics. 

This infection occurs in less than 1 percent of patients

Droopy Eyes (Ptosis)

Mildly droopy eyes may occur for the first day or two after surgery. Although uncommon, some people may experience droopy eyelids for longer, with the condition usually resolving itself within six months. 

If the eyes remain droopy after six months, surgery may be needed to strengthen the eyelid muscles. Some form of ptosis has been reported in about 5 to 20 percent of patients after cataract surgery

Inflammation

Some swelling after surgery is normal, but excessive swelling may be an indication of inflammation. Inflammation is more common among individuals who had especially dense or large cataracts. It can cause blurred and foggy vision. 

Anti-inflammatory eye drops can often reduce inflammation and swelling within a week or sooner. Medications may also be used.

Dislocation of the Artificial Lens

After cataract surgery, an intraocular lens (IOL) transplant is (usually) placed on the eye. In rare cases, this lens can become dislodged or dislocated. If this happens, the patient may experience double vision or greatly reduced sharpness in vision. 

This is usually corrected by moving the lens into the correct position or replacing the lens. Sometimes, a surgical process (vitrectomy) to remove the gel in the back of the eye is also part of the treatment. Dislocation of the IOL after cataract surgery occurs in less than 3 percent of patients. 

Retinal Detachment

Another risk of cataract surgery is retinal detachment, which happens when the retina (the light-sensitive tissue that covers the surface of the eye) develops a hole or a tear and falls away (or detaches) from the wall of the eye. If this happens, the retina loses access to the blood supply it needs to keep its cells healthy. 

Without this supply, the cells die off and do not regenerate. This can lead to a permanent loss of vision because the retina processes visual information and communicates that to the brain. 

According to the Ophthalmology Journal, retinal detachment happens in 1 out of every 3,000 instances of cataract surgery. When treatable, it requires immediate surgery. 

Secondary Cataracts

Posterior capsule opacity, also known as posterior capsule opacification (PCO), is a condition that may affect up to 20 percent of patients after cataract surgery. This condition is sometimes known as secondary cataracts or aftercataracts

PCO occurs when the back part of the lens capsule (which is left untouched during cataract surgery) becomes cloudy. Secondary cataracts can develop months or even years after surgery. Fortunately, the condition is easily treated with a simple outpatient procedure, YAG laser capsulotomy, which often only takes a few minutes. 

Ineffective Surgery

In some cases, cataract surgery may be ineffective at improving vision. For example, glaucoma and macular degeneration cause their own damage to the eye. It might be necessary for other conditions to be treated first before cataracts can be successfully removed through surgery.

In some cases, cataract surgery may be ineffective at improving vision. For example, glaucoma and macular degeneration cause their own damage to the eye. It might be necessary for those other conditions to be treated first before cataracts can be successfully removed through surgery.

A Safe Procedure

Cataract surgery is a proven low-risk procedure with a success rate of about 99 percent

Still, patients should watch for any symptoms of a possible complication after surgery, and alert their doctor to any pre-existing health conditions during their initial preoperative consultation.

References

  1. Considering Cataract Surgery? What You Should Know. (September 2016). Harvard Medical School.
  2. Post-Cataract Surgery Endophthalmitis: Brief Literature Review. (September 2016). Journal of Current Ophthalmology.
  3. The Incidence of Retinal Detachment After Cataract Surgery. (September 2012). The Open Ophthalmology Journal.
  4. Possible Side Effects and Complications After Cataract Surgery. (August 2021) AARP.
  5. A Systematic Overview of the Incidence of Posterior Capsule Opacification. (July 1998). Ophthalmology.
  6. Risk of Late Intraocular Lens Dislocation After Cataract Surgery, 1980-2009: A Population-Based Study. (October 2011). American Journal of Ophthalmology.
  7. Incidence and Characteristics of Endophthalmitis after Cataract Surgery in Poland, during 2010–2015. (June 2019). International Journal of Environmental Research and Public Health.
  8. Comparison of Incidence of Ptosis after Combined Phacotrabeculectomy With Mitomycin C and Phacoemulsification. (December 2015) Indian Journal of Ophthalmology.
  9. Dislocated IOL. Retina Macula Institute.
  10. Late Intraocular Lens Dislocation Following Scleral Depression: A Case Report. (January 2020). BMC Ophthalmology.
  11. What Are Secondary Cataracts? University of Central Florida Health.
  12. Cataract Surgery: What You Should Know. (March 2018). UCI Health.

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