Dealing with Cataract Surgery Complications

Cloudy vision and PCO

Following cataract surgery, a minority of patients may experience the onset of cloudy vision. This is caused by posterior capsule opacification (PCO) and is sometimes known as a ‘secondary cataract’. PCO is one of the most common cataract surgery complications, but affects fewer than 10% of all patients and is easily treated.

It occurs when a membrane grows in the lens capsule, over the artificial intraocular lens that was inserted during cataract surgery. Posterior capsule opacification typically develops within two years of the original cataract surgery procedure.

PCO can be treated with a simple and quick procedure. Using a laser, the surgeon removes the unwanted part of the lens capsule that has grown over the lens. This is a low-risk, bladeless operation that can be completed in minutes. Eyesight should return to normal within a few days of the procedure.

Other, rare complications

Other cataract surgery complications are much more unusual. They can occur during the operation or afterwards. Most complications are not serious and can be treated or rectified with further treatment.

Possible (but rare) complications during cataract surgery include:

• Damage to the lens capsule or other parts of the eye – 0.3% risk
• Bleeding or infection – 1 in 5000 risk – we have had no cases at OCL
• Part of the cataract not being removed successfully – we have had no cases at OCL

With a skilled surgeon, these risks are minimal. Laser assisted cataract surgery can improve success rates still further, due to its high precision and reduced risk of infection.

Sometimes, in a small minority of cases, complications can occur during recovery, or further down the line. These may include:

• Inflammation or redness in the eye that has been treated
• Retinal swelling
• Corneal swelling
• A feeling of pressure in the eye
• Drooping eyelid
• Dislocated IOL – there is a 1 in 5000 risk of this occurring. This occurs if the artificial lens (IOL) inserted during surgery becomes dislocated and moves out of the position it was placed in by the surgeon. This rare complication can be treated with a second lens implantation procedure
• Retinal detachment or tears. This is a serious complication that requires immediate medical attention. Seek medical advice if you experience flashes, floaters or distorted vision. The risk of retinal issues is 1% after cataract surgery and rarely occurs at the same time as surgery. Increased risk occurs in people who are very shortsighted, who have had previous retinal problems or who have complicated cataract surgery. Retinal detachment is rare, affecting 1 in 10,000 people (and not always as a result of surgery). If seen quickly enough, most patients can have the retina reattached to restore vision

Risk factors for complications are: increasing age, male gender, presence of glaucoma, diabetic retinopathy, brunescent/white cataract, no fundal view/vitreous opacities, pseudo-exfoliation/phacodonesis, reducing pupil size, eye ball length of 26.0 mm or greater, the use of the alpha-blocker doxazosin or tamsulosin, inability to lie flat and trainee surgeons performing operations (we only have consultant surgeons at OCL).

If you are worried about any symptoms you are experiencing following cataract surgery, always get your eyes checked by your specialist.

Talk to your specialist

Before surgery, always be sure to discuss any worries you may have about possible cataract surgery complications. Your surgeon will be able to tailor their advice to your own particular procedure, taking into account your unique medical history.