 Risks of Surgery
Cataract surgery is one of the most successful
procedures in modern medicine. More than 99% of patients
experience an improvement in their vision. However, even
in the best hands complications may still occur.
Tears of the posterior lens capsule.
The lens capsule is the transparent bag which
surrounds the lens. During cataract surgery a circular
hole is torn in the front surface of the capsular bag so
the surgeon can then remove the cloudy lens material.
Every effort is made to preserve the remainder of the
capsular bag so that the implant lens can be placed in
this bag once the cataract has been removed. Tears in
the back (posterior) of the capsular bag occur in
approximately 2-3% of cases (Royal College of
Ophthalmologists National Audit 1997). Although the
complication rate for surgery carried out by a
Consultant Ophthalmologist is often closer to 0.5%.
Should this complication arise it is usually still
possible to place an intraocular lens on top of the
remaining capsule. Very occasionally a small piece of
lens material falls into the vitreous jelly, if this
happens a second operation may be necessary to remove
this lens material.
Choroidal Haemorrhage
Bleeding within the layer of blood vessels that
nourish the retina is a very rare and unpredictable
complication of cataract surgery. If the bleeding is
localized the eye may recover but in mores severe cases
permanent, severe visual loss may occur.
Endophthalmitis (infection inside the eye)
This is potentially the most serious complication of
cataract surgery, but fortunately it is also the least
common (approximately between 1 in 1,000 to 1 in 1,500
operations). Every precaution before, during and after
surgery is taken to prevent the development of
endophthalmitis. The first signs and symptoms are of
increasing pain, redness and deteriorating vision in the
first 5-7 days after surgery. If these symptoms occur
you should contact your surgeon immediately.
Posterior vitreous detachment and retinal detachment
Cataract surgery slightly increases the risk of
posterior vitreous detachment and subsequent retinal
detachment.
Myopic patients and those who suffer a posterior
capsule rupture during surgery are at greater risk that
normal sighted patients or those who have uncomplicated
surgery. New floaters in your field of vision and
flashes of light are warning signs and if they occur you
should contact your surgeon immediately.
Cystoid macular oedema (CMO)
The centre of the retina that serves detailed central
vision is called the macula. After routine cataract
surgery inflammation may cause swelling in this area of
the retina, which is referred to as cystoid macular
oedema. This condition results in blurred central vision
3-6 weeks after surgery and in the majority of cases
resolves without treatment after 2-3 months.
Occasionally anti-inflammatory drops or tablets may be
prescribed to speed up recovery.
Intraocular lens errors
During cataract surgery the strength of the
intraocular lens implant is chosen to help correct any
previous long or short sightedness. The aim of surgery
in most cases is to provide good distance vision with no
glasses, or just a weak spectacle correction, but
reading glasses will be needed for close work. Although
the equipment used to calculate the strength of the
implant is very accurate there is still the possibility
that small errors can occur, especially in very long or
short sighted eyes. This may mean that following surgery
you may be slightly more long or short sighted than your
surgeon had planned. In very rare cases a second
operation may be needed to replace the implant with one
of a different strength.
Posterior Capsule Opacification (PCO)
Thickening of the posterior lens capsule occurs in
approximately 1 in 4 patients following cataract
surgery. If you notice a gradual decline in vision 1-2
years after cataract surgery this is the most common
cause. PCO is often detected by your optician who will
then refer you back to the clinic for laser treatment. This is carried out
using a laser mounted on a slit lamp. Treatment only
takes 2-3 minutes to carry out and is painless. For
further information click
here.
Posterior capsule opacification
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Treatment by laser
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