Cataract surgery does wonders – one day you can’t see, and 20 minutes later, you can. Okay, it’s not quite as simple as that, but it’s pretty close. But as with any surgical procedure, there is the risk of complications and side effects, whether it’s during the operation or in the following weeks as your eyes recover.
Cataract surgery in the USA
Cataract surgery is one of the most commonly performed procedures worldwide, due to the age-related nature of cataracts. In the USA alone, almost 4 million cataract operations are performed each year.
Risks of cataract surgery
Some complications of cataract surgery are more common than others and range from a mild annoyance to sight-threatening. Immediately after a cataract operation you can expect some redness, tenderness, a gritty sensation, glare sensitivity, and slightly blurred vision that improves over the following weeks. Though cataract surgery recovery can vary slightly from person to person, anything outside of the expected after your operation should be tended to immediately.
Here are some cataract surgery risks to be aware of.
Infection
Though every precaution is taken during and even before your cataract operation, making any sort of incision anywhere in the body carries a risk of introducing germs. During the cataract operation, a cut is made at the front of the eye to allow the surgeon’s tools to get to the cataract behind the colored iris. An infection from cataract surgery, known as endophthalmitis, is very rare (less than 0.1%) but can be devastating for your vision.
Prolonged inflammation
You can expect some inflammation and the associated redness and tenderness after your operation. This typically resolves within the month as you use your prescribed eye drops. For some people, the inflammation may persist after they’ve been instructed to finish their medications, which can affect your comfort and vision.
Exacerbation of pre-existing eye diseases
The disruption and trauma to your eye from cataract surgery, even if for a good cause (to get that cataract out), can exacerbate a pre-existing eye condition. This includes worsening or the development of diabetic retinopathy or dry eye syndrome.
Retinal detachment
The retina is the light-sensing tissue that lines the back of the eye. A retinal detachment occurs when this tissue comes away from the underlying layer, resulting in vision loss in that area of the detachment. Though a retinal detachment can happen to anyone at any time, cataract surgery can increase the risk of this happening. The common symptoms of a retinal detachment are seeing flashing lights, floating shadows, or missing part of your sight.
Macular edema
The macula is the part of the eye responsible for your fine detail central vision. The normal inflammation introduced by cataract surgery can result in an accumulation of fluid under the macula during the post-operative period, known as cystoid macular edema. Cystoid macular edema typically self-resolves without permanent effects to your vision, but still needs to be monitored by an eye doctor and treated if severe.
Intraocular lens complications
The intraocular lens (IOL) is the artificial lens implant that replaces your natural cloudy lens once it’s been removed through cataract surgery. This IOL is supposed to sit within the membrane that previously held your natural lens, but occasionally it can move out of position, known as a dislocated IOL. This will affect your vision in that eye and can also lead to other complications like inflammation and bleeding.
Dysphotopsia
This refers to unwanted visual disturbances. It can either be a positive dysphotopsia, involving haloes, flashes or streaks of light; or negative dysphotopsia, such as seeing crescent-shaped shadows at the edge of your vision. The cause of dysphotopsia after cataract surgery isn’t fully understood, but may be due to a complex interaction between the optics of the IOL and your eye.
How to minimize cataract surgery complications
If you want to reduce your risk of complications after cataract surgery as much as possible, there’s no simpler way to say it – do what your eye doctor tells you to do.
In the lead-up to your cataract operation, this can include adhering to good eyelid hygiene such as lid wipes and warm compresses if you have blepharitis. This can help to reduce your risk of an infection or post-op dry eye.
After your operation, you’ll be provided instructions on what to do (and what not to do) to help you through your recovery period. This will involve using medicated eye drops, keeping your eye clean and safe from trauma, and avoiding certain activities and environments. And always remember the red flags that need urgent attention – increasing redness, pain, or blurred vision.