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Cataract Surgery – Risks Involved

Modern eye surgical procedures are so advanced that about 98% of the people who have cataract surgery have wonderful outcomes and vision that is greatly improved. This is a significant figure and a testament as to how far we have come with this procedure. However, there is that 2% that we need to be concerned with and what can go wrong in those cases.

Infection in the eye, the most common risk

One of the most common risks of cataract surgery is Endophthalmitis, which is an infection inside the eye. To prevent this from happening, antibiotic eye drops are administered on the day of the surgery. In most cases, this procedure is all that is needed, but in some cases infection will occur. The statistics for post operative infection are 1 in 3000 surgeries.

A less common risk of cataract surgery is cystoid macular edema. The macula is the central part of the retina. Sometimes, after surgery, this part becomes inflamed, which results in a blurring of vision. A test is then given to determine the extent of the swelling. In some cases, steroids need to be injected into the area itself in order to bring down the swelling, which is always a risk in itself.

Retinal detachment – higher risk for the shortsighted

Another uncommon risk of cataract surgery is retinal detachment. Occasionally during surgery fluid seeps through a tear in the retina. When this happens, the retina detaches from the back of the eye. Patients who are nearsighted have more of a chance of retinal detachment than other patients. This occurs in about one half of one percent of all surgeries.

Choroidal Hemorrhage - the most serious risk

The most serious complication from cataract surgery is choroidal hemorrhage. The choroid is a web of blood vessels that supplies that retina with blood. Sometimes, during surgery, the choroid will bleed. This is mostly common in patients with high blood pressure and glaucoma. If the bleeding is restricted to a small area, then patients usually recover without much visual loss. However, in the most severe cases, patients can end up having complete loss of vision.

Can cataracts return after surgery?

In some cases, within months to years after cataract surgery, the thin lens capsule may become cloudy, and you may have the sensation that the cataract is returning because your vision is becoming blurry again. This process is termed posterior capsule opacification, or a "secondary cataract." To restore vision, a laser is used in the office to painlessly create a hole in the cloudy bag. This procedure takes only a few minutes in the office, and vision usually improves rapidly.

Do you really need to risk cataract surgery?

Eye-care professionals may mention during a routine eye exam that you have early cataract development even if you are not yet experiencing visual symptoms. Although your doctor will be able to tell when you first begin to develop cataracts, you will generally be the first person to notice changes in your vision that may require cataract surgery. Clouding of the lens may start to be seen at any age, but it is uncommon before the age of 40. However, a large majority of people will not begin to have symptoms from their cataracts until many years after they begin to develop. Cataracts can be safely observed without treatment until you notice changes in your vision.

Cataract surgery is recommended for most individuals who have vision loss and are symptomatic from a cataract. If you have significant eye disease unrelated to cataracts that limits your vision, your ophthalmologist may not recommend surgery. Sometimes after trauma to the eye or previous eye surgery, a cataract may make it difficult for your eye-care professional to see the retina at the back of the eye. In these cases, it may still be appropriate to remove the cataract so that further retinal or optic nerve evaluation and treatment can occur. The type of surgery can be tailored to individuals based on coexisting medical problems. Cataract surgery is generally performed with minimal sedation and generally takes less than 30 minutes. Therefore the surgery does not put significant strain on the heart or the lungs.

The most dangerous risks of cataract surgery are fortunately very rare because of today's technology. Still, it is important that you are aware of them.