Last updated on May 5th, 2019 at 06:51 am
Cataract surgery complications are few, and cataract surgery is amongst the most typical and most successful surgeries carried out today.
Inning accordance with the American Society of Cataract and Refractive Surgery (ASCRS), 3 million Americans go through cataract surgery each year, with a general success rate of 98 percent or higher.
Also, a research study of more than 200,000 Medicare beneficiaries who went through cataract surgery between 1994 and 2006 discovered that 99.5 percent of patients had no severe postoperative complications and the risk of severe complications has reduced with advances in surgical instruments and methods.
Complications – What to Expect After Cataract Surgery?
Prospective cataract surgery complications include:
- Posterior pill opacity (PCO).
- Intraocular lens dislocation.
- Eye inflammation.
- Light level of sensitivity.
- Photopsia (perceived flashes of light).
- Macular edema (swelling of the central retina).
- Ptosis (droopy eyelid).
- Ocular hypertension (elevated eye pressure).
When cataract surgery complications do take place, the majority of are small and can be successfully dealt with clinically or with extra surgery.
Posterior Pill Opacity – A Typical Cataract Surgery Problem
One of the most common cataract surgery complications is a posterior pill opacity (also called posterior pill opacification or PCO).
Although some individuals call PCO a “secondary cataract,” it actually is not a cataract. Once a cataract is gotten rid of, it does not return.
During cataract surgery, your surgeon will eliminate the cloudy natural lens of your eye (cataract) and replace it with an intraocular lens (IOL). Much of the thin clear membrane that surrounds the natural lens (called the lens capsule) is left intact during surgery and the IOL generally is implanted within it.
When the cataract is removed, your surgeon makes every effort to maintain the stability of the lens pill, and normally your vision after cataract surgery should be really clear.
Nevertheless, in about 20 percent of patients, the posterior part of the pill ends up being hazy some time during cataract surgery recovery or even months later on, triggering PCO. Posterior capsule opacification occurs since lens epithelial cells staying after cataract surgery have actually grown on the pill.
In many cases, if the condition advances considerably, your vision may be worse than it was prior to cataract surgery.
Less than 10 out of 100 people have complications from cataract surgery that might threaten their sight or need further surgery. The rate of complications increases in people who have other eye diseases in addition to the cataract.
Treating Posterior Capsule Opacity
Luckily, a YAG laser can treat posterior pill opacity securely, successfully and painlessly. This procedure, referred to as YAG laser capsulotomy, frequently can be performed in your doctor’s workplace.
YAG laser capsulotomy includes simply a couple of simple actions:
- Generally the eye is dilated before the procedure, with dilating eye drops.
- A laser removes the hazy posterior capsule from your line of vision without making an incision or “touching” the eye.
- Lots of ophthalmologists recommend anti-inflammatory eye drops following the procedure.
The procedure takes only a few minutes and is entirely painless; nor does pain take place post-operatively.
You should remain still during the procedure, however. Extremely uncooperative patients, such as children and mentally disabled people, may need sedation.
Following a YAG laser capsulotomy, you might resume normal activities immediately. You may experience some floaters afterward. These will likely solve within a couple of weeks.
Many people can anticipate their vision to improve within a day. Similar to any eye procedure, however, call your optometrist immediately if vision worsens or cannot improve.
Since the YAG laser removes the central zone of the cloudy posterior capsule behind the intraocular lens, the condition can not return. So only one laser treatment is required to completely get rid of vision loss caused by posterior capsule opacification after cataract surgery.
YAG Laser Capsulotomy Threats
Although a YAG laser capsulotomy positions small extra risk, in general the procedure is incredibly safe. The most important risk is that the retina can become separated from the inner back of the eye.
Statistics suggest that the life time risk of a separated retina as a cataract surgery issue in the United States has to do with 1 percent. That number increases to about 2 percent after YAG laser capsulotomy. It is necessary to be aware of this cataract surgery risk.
Dislocated Intraocular Lenses
Another example of cataract surgery complications is malpositioned or dislocated intraocular lenses. You might see the edge of the lens implant, or you might even develop double vision. If the intraocular lens becomes too badly dislocated, your visual skill might decrease significantly.
How can an IOL become malpositioned or dislocated?
In a lot of cataract surgical treatments, the intraocular lens is positioned inside the “capsular bag,” which includes the cloudy natural lens or cataract of the eye.
Ophthalmologists make every attempt to maintain the integrity of the capsular bag so that the intraocular lens can be placed correctly within it. But the capsular bag is very thin– roughly the thickness of a single red blood cell– and can sometimes rupture or break.
Likewise, the capsular bag itself might dislocate due to weakness or breakage of the fibers (zonules) that hold it in location, resulting in a condition known as zonular dialysis. This condition positions you at risk of malpositioning or dislocation of the lens implant.
Even without underlying complications, intraocular lenses can still dislocate– especially if among the springy “arms” holding the lens in location is positioned incorrectly inside the capsular bag or becomes malpositioned later on.
When an intraocular lens implant is malpositioned or dislocated, your cataract surgeon can most likely reposition it in a second procedure. In some cases, the lens implant need to be sewn in location, or another type of lens need to be implanted.
If IOL dislocation takes place following a current cataract surgery, repositioning the lens needs to be done quickly. This is since lens implants start to “scar” into location around 3 months after initial implantation and can end up being much more challenging to get rid of.
If you do experience a malpositioned or dislocated intraocular implant, your opportunities of a good outcome following a second procedure are very good if you and your surgeon act without delay.
More than 14,000 cataract surgeries carried out in between January 1980 and May 2009 discovered that the risk of late IOL dislocation after cataract surgery was very low: At 10 years after surgery, the cumulative risk was 0.1 percent; at Twenty Years, it was 0.7 percent; and at 25 years, it was 1.7 percent.
Other Cataract Surgery Complications
Other possible cataract surgery complications vary from minor eye swelling to devastating vision loss. The risk of severe vision loss is really rare and may occur as an outcome of infection or bleeding inside the eye.
Some cataract surgery complications occur a long time later on. For example, a detached retina can take place months or years after a completely effective cataract procedure.
A lot of patients with retinal detachment have a great outcome if they see their eye doctor when symptoms first start and treatment is done instantly. Nevertheless, a little portion will have substantially and completely lowered vision.
Make certain to report floaters, flashes of light and a curtain-like vision loss to your eye doctor right away, as these symptoms may indicate a retinal detachment has occurred.
Other prospective cataract surgery complications are minor and may include:
- Swelling of the cornea or retina.
- Increased pressure in the eye (ocular hypertension).
- Droopy eyelid (ptosis).
Small complications usually clean up with medications and more recovery time.
Vision After Cataract Surgery
According to ASCRS, research studies show that 95 percent of patients who pick a standard IOL for cataract surgery have their vision totally restored to its pre-cataract state, and if you choose a premium IOL your vision may be even much better than it was previously.
People whose vision fails to improve after cataract surgery often have underlying eye disorders, such as age-related macular degeneration, diabetic retinopathy and other eye conditions. A few of these people may gain from other treatments or from low vision aids.