Cataract surgery is a very common procedure, and is considered very safe, but it is not without risks. In addition to the general risks of surgery and the risks associated with anesthesia, a cataract procedure poses its own unique potential complications.
It is important to remember that the odds of complications and issues after surgery increase with the age of the patient. In the United States, half of all people who reach their 80th birthday have cataracts, making this surgery one that is most often performed on the older patient. While every surgical procedure performed today has a risk of death, that risk is very small, even in the elderly.
Older patients frequently have preexisting conditions that can increase the level of risk associated with surgery. Hypertension, diabetes, cancer and even thyroid conditions can make a procedure more difficult or slow the healing process afterward. Diabetes is worth a specific mention, as poorly controlled blood glucose levels before, during and after the procedure can dramatically alter healing time.
In addition, some medications can increase the risk of complications. Medication that helps prevent blood clots, commonly known as "blood thinners," can make bleeding more likely. Steroids, especially when taken long-term, can increase the risk of infection.
While complications after cataract surgery are not common, they are certainly possible, and vary with the type of cataract and the procedure used to treat the condition. The most frequent issues patients experience are the following:
Infection: Signs of infection should be reported to your physician immediately. These signs may include redness, discharge, swelling and a change in the color of the fluid coming from your eye. Fluid from the eye in small amounts is normal after surgery, but green, yellow or milky fluid is a sign of infection and must be treated promptly.
Bleeding: It is possible to have bleeding at the site of the surgery. Your physician should be made aware if you have this issue.
Blindness: Any eye surgery has a risk of blindness. It is a rare complication, but it is possible that vision can be completely lost in the eye, due to an issue during surgery or a complication that occurs after the procedure.
Decrease in Vision: For some patients, the surgery may remove the cataract, but result in a decrease in visual acuity. Most patients report seeing much better after the procedure, and with the cloudy cataract gone, experience a far more vivid range of colors.
Retinal Detachment: Retinal detachment is a medical emergency. The faster treatment is obtained, the greater the chances for a full recovery. An early sign of a detachment is seeing flashers, floaters or cobwebs. If you have had recent cataract surgery and are now seeing spots, blinking spots of light, or it seems as though something is floating through your visual field, seek immediate attention from your physician or the emergency room.
Itching: Most itching is a normal side effect of the healing process. However, if the itching suddenly intensifies after several days of improvement, or is so severe that it is nearly intolerable, discuss this with your physician. This may be a sign of infection, or it may be typical of the healing process. Your physician may be able to prescribe eye drops that can relieve the issue.
Inflammation: Some inflammation and redness after the procedure is likely, but an increase in inflammation after the healing process has begun may indicate a problem.
Double Vision: Most common in the days following the procedure, double vision often resolves as healing continues. It is worth mentioning to your physician, but is not typically a long-term problem.
High/Low Eye Pressure: For some patients, the pressure inside the eye is altered by the procedure. This is not a condition that patients usually detect; it is often found in follow-up exams performed by the surgeon and is then treated.
Blurry Vision: Most common in the days immediately following surgery, blurry vision typically improves over time. If you experience blurry vision, refrain from driving until your vision improves and it is safe to do so.
Facts About Cataract. National Eye Institute. Accessed 2012. http://www.nei.nih.gov/health/cataract/cataract_facts.asp#4c