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What are the potential complications of cataract surgery?

Cataract surgery has become a very safe procedure and hence the surgery is indicated today when you feel that it is impacting on your quality of life. Like all other surgery, it has potential complications. Most people have no complications during or after surgery, but it is important for you to understand the possible risks involved.

Infection (about 1 in 8000)

Generally speaking , there is a 1 in a 1000 risk of infection occurring after the surgery. This potential complication is therefore taken extremely seriously and everything possible is done to prevent this from happening. Recently, from around 2007, it has become common practice to put an antibiotic inside the eye at the completion of surgery. This practice has greatly reduced the risk of infection and it is now around 1 in 8000 cases. If infection does occur, it will usually be within 3 to 5 days following the surgery and that is why we like seeing you again 5 to 7 days after surgery to exclude this.

Tear / Vitreous Loss (about 1 in 100)

This is also an uncommon complication. It happens to doctors in training about 1 in 20 times but in experienced hands, it occurs around 1 in 100 cases. It can be managed very well most times but on occasion, it may not be possible to place an IOL in the eye at the time of surgery. This means that the sight will be poor after surgery until such a time that a 2nd operation is done to insert an IOL. A contact lens can be worn meanwhile to restore the vision. If the capsular tear results in vitreous loss (jelly from the back of the eye coming into the front compartment of the eye), the risk of retinal detachment is increased.

Dropped Nucleus

Sometimes during surgery the capsule of the lens can get torn, and if this happens early on in the procedure, some or the entire cataract may fall into the back of your eye. If this happens, the surgery is completed without removing the fallen piece of cataract. This is best removed on a separate occasion by a vitreo-retinal specialist in order to avoid damage to the retina. Our surgeon is also vitreo-retinal specialists and can proceed to do the retinal operation needed to remove the dropped nucleus from the back of your eye.

Incorrect IOL strength

The risk for this occurring is also very low thanks to the development of technology to improve the IOL calculations. Refractive surprises, as they are called, do occur however and can be very successfully managed by either exchanging the IOL for one of a different power or by corneal laser surgery.

Expulsive Haemorrhage

This is very uncommon nowadays due to the very small incision sizes but it mentioned because it can have devastating consequences for the vision. The sight may be lost completely if this occurs. It is an uncontrolled hemorrhaging into the eye from the choroid layer within the eye. The surgery is aborted immediately after a stitch has been placed in the corneal incision and once things have settled down, the surgery is completed some weeks later.

Corneal Swelling

The cornea can swell temporarily after the surgery and this leads to blurred vision. It almost always clears up within days. Very rarely, the swelling remains permanent and a corneal graft / transplant may be required.

Subconjunctival haemorrhage

This is nothing but a temporary bruise that will clear up spontaneously even though it may look quite serious to the casual observer.

Posterior capsular opacification

The IOL rests on the natural lens’s capsule and this same capsule can sometimes become cloudy again. It may simulate the same symptoms that were present when the cataract was in the eye. Today, this is very easily treated with a laser called a Yag-laser that is done in the consulting rooms at the clinic. PCO may occur months to years after the cataract surgery.

Cystoid Macular Edema (CME)

Occasionally fluid can accumulate at the back of the eye in the macula after cataract surgery. This results in blurring of vision and even distortion of vision. It is treated with drops and tablets and normally responds very well to treatment to clear up completely.

Retinal detachment

This is a rare complication of cataract surgery. It is more common after complicated surgery for very short-sighted people.  It is treated surgically by a vitreo-retinal surgeon. Retinal detachment occurs more commonly and spontaneously in the short-sighted (myopic) population.

Other Complications.

There are other complications that can occur too but they are so infrequent and so unlikely to be encountered, that they are not mentioned here. The most frequent complications and the complications that affect vision most drastically have all been covered here. If you understand these, you have a very good understanding of the risks of cataract surgery.

Do you have a question that we haven’t satisfactorily answered above? Please contact us on 0113465025/ 0815455385 Monday-Friday 8am-5.00pm.

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  • Address:159 Rivonia Road Morningside Sandton
  • Phone:011 346 5025
  • Phone:011 346 5088
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