As with any surgical procedure, complications may occur before, during, and after cataract surgery. The risks of cataract surgery include infection, swelling of the retina, cloudy vision, and retinal detachment.
The eye’s lens is a transparent, curved structure located just behind the pupil. A healthy lens has the lowest water content in the human body.
- changes occur in the ionic components of the lens
- compacted lens material accumulates deep within the lens
- pigmentation discolors the lens
- the lens proteins break down
Each of the above factors interferes with the lens’ ability to transmit focused light rays to the retina.
This article explores the risks and complications associated with cataract surgeries, the recovery, and answers to some commonly asked questions about the procedure.
Surgery is the safest, most effective, and only approved way to remove cataracts.
During cataract surgery, an ophthalmologist makes a small, painless incision along the edge of the clear cornea, removes the cloudy lens using small instruments, and replaces it with an artificial lens implant.
The surgery is safe and low risk, but the risk of many postoperative complications relates to the overall health of the individual’s eyes.
Most postoperative complications are easy to diagnose, and prompt treatment usually delivers favorable outcomes. If someone suspects they may be experiencing a complication following cataract surgery, they should consult their ophthalmologist immediately.
Postoperative infections are uncommon. Bacteria may enter the eye during or after the surgery can result in an infection.
Endophthalmitis is one of the
The most common symptoms of endophthalmitis include:
- eye pain that gets worse after eye surgery
- white or yellow pus discharge
- red eyes
- swollen or puffy eyelids
- reduced or blurred vision, or loss of vision
Inflammation and swelling are expected results after surgery, especially if a person has dense or large cataracts or the surgery becomes prolonged. A person may continue to have foggy or blurred vision immediately after surgery, most
Treating postoperative corneal edema with nonsteroidal anti-inflammatory drug (NSAID) eye drops can help reduce swelling within a few days or a week. Additional surgery may become necessary if vision does not improve.
Suprachoroidal hemorrhage (SCH) is a rare but
Early recognition of SCH and prompt closure of surgical incisions stabilizes eye pressure. Excess blood can be safely drained to protect the ocular contents.
The following are management and treatment techniques for SCH:
- Wound closure: Early detection of SCH is important to stop bleeding. Doctors may need to surgically remove prolapsed tissue to promote wound closure.
- Deepening of the anterior chamber: The anterior chamber is the part of the eye between the iris and cornea. Doctors can deepen this chamber by injecting gel or air into it.
- Drainage: Surgical drainage may be an option in some cases of SCH. Doctors will determine the best line of treatment.
However, blurry vision can also be a symptom of more serious complications such as intraocular lens dislocation or posterior capsular opacification.
Treatment of persistent blurriness after cataract surgery depends on its cause. The surgeon may
Light sensitivity can occur after cataract surgery due to eye dryness.
However, when the eyes reflexively squint or close after exposure to light, the person may have iritis. Iritis is the swelling and irritation of the colored part of the eye.
Doctors treat this with steroid eye drops. Experts will also recommend sunglasses to help some people.
Cystoid macular edema is the swelling of the retina. It only occurs in 1–2% of cataract surgery cases.
It is the most common complication in uncomplicated cataract surgeries and occurs 6–8 weeks after the operation.
- distorted vision
- reduced vision
- loss of central vision
The treatments for the condition
A lid retraction injury happens due to the stretching of aging upper eyelid muscle fibers by the instrument that spreads the eyelids to better expose the eye during surgery.
Most individuals recover without treatment. Doctors can
While many people will have significantly improved vision after surgery, some may continue having visual complaints. They may see unwanted optical images, such as shadows, glares, and starbursts.
These symptoms may
- intraocular lens (IOL) repositioning
- IOL substitution
- reopening the lens capsule with a clinical laser procedure
This change may be short term or permanent. Doctors cannot predict whether the pressure will rise or fall after cataract surgery.
Depending on the cause of increased eye pressure, doctors may reverse postoperative IOP elevation with the following:
- pressure-lowering eye drops
- anti-inflammation eye drops
- outpatient laser treatment
Posterior cataract opacification (PCO), or secondary cataract, is when the posterior capsule — the membrane that holds the artificial lens following surgery — becomes cloudy.
It can occur weeks or months after the surgery but most frequently appears years after the cataract removal.
A treatment called YAG laser capsulotomy is a quick and safe laser procedure that can help treat PCO and restore vision.
During the surgical operation, a hole may develop in the posterior capsule. This may cause the gel behind the eye (vitreous humor) to leak, which increases the risk of other complications, such as retinal detachment and glaucoma.
Early detection of capsular rupture is vital for preventing further damage. Doctors remove any vitreous gel that enters the front of the eye. The surgeon may implant the artificial lens in a different position or delay inserting a lens implant.
The retina may peel away from the back of the eye, causing a tear or total detachment. This is more
- flashes of light
- curtain or shadow appearing on the peripheral vision
- burst of floaters
This requires urgent surgery to restore vision by repairing the tear or reattaching the retina.
Rarely, the lens implant may move or dislocate. This can happen when the posterior capsule ruptures or breaks. It can cause double vision or a significant decrease in visual acuity.
A surgeon may perform a second surgery to correct the placement of the implant. Some surgeons may use a different lens or sew the lens in place.
After surgery, the person may experience the following expected side effects:
- scratchy or gritty feeling in the eye
- sticky or uncomfortable feeling in the eye
- excessive tearing
Doctors typically give people topical antibiotics, corticosteroids, or NSAID eye drops that they should use for
Vision may still get blurry, but a person will see better in as little as 1–3 days after surgery. However, it could take 3–10 weeks to see its full effect. Following surgery, a person may still need to wear eyeglasses, especially when reading.
Below are some frequently asked questions about the risks of cataract surgery.
Is cataract surgery high risk?
Any surgery carries some risk, but cataract surgery is generally safe and low risk.
What are the negatives of cataract surgery?
One potential disadvantage of cataract surgery is the cost. Medicare and private insurance will usually cover 80% of cataract surgery with a standard IOL implant.
For individuals seeking enhancements such as femtosecond laser cataract removal and premium IOL implantation, average out-of-pocket costs run between $3,000 and $6,000 per eye.
While uncommon, complications may also occur
What is the success rate for cataract surgery?
Cataract surgery has a high success rate compared with other types of surgeries. An older study of 221,000 cataract surgeries found that 99.5% had no serious complications.
What percentage of cataract surgeries have complications?
Technological advancements have led to a significant decline in complications associated with cataract surgeries. Despite this, about 2% of people who undergo cataract surgery may experience complications.
Cataract surgery is a safe and low risk procedure with a high success rate. People may experience typical side effects after the surgery and should follow their doctor’s advice to keep them manageable.
It may also carry potential complications such as inflammation, secondary cataract, posterior capsule rupture, torn or detached retina, and dislocated lens implants. Some resolve independently, while others are serious and require urgent treatment.