Can cataract surgery have side effects?

Cataract surgery is one of the safest and most successful operations performed in the world. For the vast majority of people who have cataract surgery, it results in improved vision and very good outcomes. However cataract surgery, like all surgery, is not risk free. There are some rare complications that can occur. These are rare, but if they occur, can affect the final quality of the vision and potentially the long-term health of the eye

1. The lens’ bag can break.

A cataract is a natural lens that has become opaque and obscures vision. In cataract surgery the cataract is taken out of it’s natural bag and an artificial lens inserted into that same bag. This bag is very delicate and rarely it can break at the time of cataract surgery. This can affect the final position of the artificial lens, which may disturb the eye’s long-term vision. Also, the gel in the centre of the eye, that normally is contained behind the bag, now has the opportunity to travel towards the front of the eye, where it does not belong, and this can cause further problems.

2. Eye infection from bacteria

While exceedingly rare, bacteria can enter the eye at the time of surgery or in the weeks following surgery. If such an infection occurs it can have devastating consequences to the eye’s vision. In modern cataract surgery an antibiotic is injected into the eye that kills all potential bacteria, which has pleasingly reduced the infection rate to almost 0%.

3. Exacerbation of pre-existing eye conditions

It is important to ensure an eye is as healthy as it can be leading up to cataract surgery. Uncontrolled diabetic eye disease, glaucoma, retinal tears, or severe dry eye can all be made worse by cataract surgery. Especially for eyes with glaucoma, cataract surgery carries several extra risks, including high eye pressure in the 1-2 days following cataract surgery which can be dangerous to the long term health of the eye. For this reason it is important to have an experienced and capable surgeon who can work hard to prevent such outcomes, and should they occur, manage them effectively for the optimal health of the eye.

4. Damage to eye structures near the cataract

The eye is a delicate and intricate organ, and the cataract operation involves precision microsurgery. Rarely structures in the eye, such as the cornea or iris, can be damaged at the time of cataract surgery. Eyes with certain pre-existing conditions, such as glaucoma or corneal disease, can sometimes be at increased risk of such a problem. As stated above, it is important to have a capable and experienced surgeon perform the surgery, who is adept at avoiding such problems as well as managing them well should they occur. This ensures the best outcomes for the eye.

While rare, it is important for anyone undertaking cataract surgery to be aware of the small but real potential for risk, and have the confidence in their surgeon and surgical team to be able to manage such problems adequately.

A/Prof Simon Skalicky is a highly experienced and well-trained cataract surgeon.