Complications with Cataract Surgery Guide

Cataract surgery involves removing the cloudy natural lens in the eye and then placing a permanent intraocular lens implant. Once the patient has recovered from the surgery, his focusing power should be restored. Part of recovering from this procedure is knowing about and being on the lookout for the possible complications with cataract surgery. Roughly 95 percent of patients who have this surgery done, however, do not experience any complications.

Glaucoma

Sometimes after cataract surgery, glaucoma may occur. This condition is characterized by intraocular pressure, or pressure building up in the eye. If the pressure in the eye stays elevated, the patient may have to have additional treatments, such as a laser procedure, additional surgery, eye drops, or pills.

Decentered Intraocular Lens

Only about 0.22 percent of patient experience this complication and the prognosis is good. This complication occurs when the artificial lens used to replace the cloudy natural lens becomes decentered due to eye structure, placement problems, or changes during healing.

Choroidal Hemorrhage

This complication occurs in about 0.07 percent of patients and the prognosis ranges from poor to good. The choroid is the composed of the blood vessels supplying the retina. During cataract surgery, these vessels may bleed, causing possible retinal detachment and pressure on the retina.

Corneal Edema

This complication occurs in about 5.18 percent of patients and the prognosis is excellent. This complication is characterized by inflammation of the cornea. This surgical procedure may be traumatic to the cornea and the common response to this trauma is inflammation.

Cystoid Macular Edema

This complication occurs in about 1.62 percent of patients and the prognosis is excellent. This complication is characterized by the the area of the retina responsible for central vision becoming inflamed. The inflammation is generally due to fluid accumulation.

Descement’s Folds

This is one of the possible complications with cataract surgery that occurs in about 2.57 percent of patients and the prognosis is excellent. Descement's layer may have folds in it due to the cornea being stressed from corneal edema or elevated intraocular pressure.

Endophalmitis

This complication occurs in about 0.25 percent of patient and the prognosis ranges from vision loss to good. This complication is an infection that can take a few hours to years after surgery to develop. Many surgeons and eye doctors consider it the worst possible complication of cataract surgery. If not diagnosed and treated promptly, vision will be destroyed by this infection. Antimicrobial eyedrops are often used after surgery to help prevent this infection.

Floppy Iris Syndrome

This complication occurs in about 0.5 percent of patients and the prognosis is excellent. Certain medications, such as Flomax, may cause this complication to occur so patients taking these medications may have to adjust the dose or stop taking it for this surgery. If the iris becomes flaccid, the iris will move in and out with interchamber intraocular pressure changes or aqueous flow changes, sometimes causing uncontrolled pupil constriction and iris prolapse. It may also make the surgery more difficult.

Hyphema

This complication occurs in about 0.07 percent of patients and the prognosis is excellent. Trauma during this surgical procedure may cause bleeding, resulting in blood making its way to the anterior chamber of the eye.

Intraocular Pressure Elevation

This complication occurs in about 2.57 percent of patients and the prognosis is excellent. This complication is characterized by elevated pressure in the eye which may result in stress on the optic nerve.

Iris Prolapse

This complication occurs in about 0.16 percent of patients and the prognosis is good. This complication is characterized by a part of the iris exiting through and/or moving toward the corneal incision.

Posterior Capsule Opacification

This complication occurs in about 1.22 percent of patients and the prognosis is excellent. It is characterized by the membrane surrounding the lens becoming cloudy. About 50 percent of patients will experience this complication over a long period of time.

Refractive Error

This complication occurs in about 54 percent of patients and the prognosis is excellent. This is characterized by the patient requiring vision corrections due to vision not being 20/20 following surgery.

Retained Lens Material

This complication with cataract surgery occurs in about 0.45 percent of patients and the prognosis is fair. This is characterized by fragments of the natural crystalline lens staying in the patient's eye.

Retinal Detachment

This complication occurs in about 0.75 to 1.65 percent of patients and the prognosis ranges from very poor with vision loss to poor. This is characterized by the retina becoming detached.

Toxic Anterior Segment Syndrome

This complication occurs in about 0.25 percent of patients and the prognosis ranges from very poor to good. This complication is characterized by a non-infectious, acute inflammation of the eye's anterior segment.

Uveitis

This complication occurs in about 3.29 percent of patients and the prognosis is excellent. This complication is characterized by the middle layer of the eye becoming inflamed.

Vitreous Detachment

The exact occurrence rate of this complication with cataract surgery is not known, but the prognosis is excellent. This complication is characterized by the vitreous detaching from the eye's inner walls.

Vitreous Loss

This complication occurs in about 0.17 percent of patients and the prognosis is good. This complication is characterized by a portion of the vitreous moving into the eye's anterior chamber.

Wound Leak

This complication occurs in about 0.14 percent of patients and the prognosis is excellent. This complication is characterized by the eye's internal fluids leaking through the incision.

Other Possible Complications

In addition to the above-mentioned complications with cataract surgery, other complications are also possible. About 0.1 percent of patients will experience an allergic reaction, but the prognosis is excellent. This allergic reaction is to the medications used after and during the surgery. Other possible complications include:

  • Astigmatism
  • Blood in the eye
  • Halos
  • Hyperopia
  • Starburst

Resources

Haddrill, M. (2010). Cataract Surgery. Retrieved on January 12, 2011 from All About Vision: https://www.allaboutvision.com/conditions/cataract-surgery.htm

Visitech. (2011). Complications of Cataract Surgery. Retrieved on January 12, 2011 from Visitech: https://www.visitech.org/complications-cataract-surgery.html