Cataract Surgery Complications - After Surgery Risks and Fails

A cataract is a cloudy, hazy or opaque region in the ordinarily clear eye lens formed on our eye lenses due to unnecessary breakage of proteins. This can lead to complete vision loss if untreated. Hence, it is imperative to remove the cataract from the eye by undergoing cataract surgery.

In cataract surgery, the eye lens will be removed and replaced with a new artificial one. Even though cataract surgery is very common, and modern equipment and techniques ensure little to no side effects, there is still room for one eye surgery complication or another. 

Modern cataract surgery is a relatively simple process, yet there are chances of complications. So, it is important to be aware of these cataract complications and report them on time to avoid developing severe issues. Here are some notable after-cataract surgery complications. These have been categorised into immediate and late complications of cataract surgery:

Immediate Cataract Complications

1. Pain: It’s one of the common eye surgery complications. If the pain increases after the surgery, then you should contact your doctor immediately. However, it is important to note that you will feel pain in the eyes right after the procedure, so do not panic if it is there for a couple of days. 
2. Posterior capsule rupture/vitreous loss: The posterior capsule could get ruptured because of a change in intraocular pressure and it may cause the loss of vitreous humour in the eye. It could happen during surgery and may result in poor vision. 
3. Bleeding: Bleeding happens after cataract surgery due to other serious health problems like — diabetes, high blood pressure, etc. Suprachoroidal Haemorrhage (SCH) is a condition where vision is affected by bleeding that the patient might suffer after the surgery. This bleeding happens due to the blood filling between the space of the choroid and the sclera. The blood comes from the ciliary arteries. It needs immediate treatment.
4. Droopy eyelid: This is a common eye problem after cataract surgery. Also known as Ptosis, this condition usually gets cured without further complications. But if it lasts for a long time (more than 6 months), then you may have to consult a doctor and go for surgery.
5. Retinal detachment: It’s an emergency problem that might lead to complete vision loss. So you need to go to the doctor as soon as possible. Some symptoms include — seeing flashes of light, feeling like a curtain covers up your eye, etc.
6. IOP (Increased Intraocular Pressure): This is another cataract operation risk that happens due to unnecessary storage of aqueous fluid. This fluid inside your eyes creates pressure when it exceeds the normal threshold. Usually, this pressure subsides within a few hours. If not it could result in other eye ailments like pain, optic nerve damage, corneal inflammation, etc.
7. Iris prolapse: It could happen just after the surgery because of the trauma or laceration of the iris. It is one of the common issues in cataract surgery and should be immediately taken care of.
8. Lens dislocation: It could occur early on because of the poor fixation of the Intra Ocular Lens (IOL) during the cataract surgery. It generally occurs from posterior pressure on the lens.
9. Swelling of macula/macular oedema: This is one of the rarest cataract surgery complications. The centre of the retina is called the macula. The macula helps to clear and sharpen our vision. A fluid may enlarge your macula after the surgery. This is known as swelling or oedema. You have to take eye drops to reduce swelling.

Late Complications of Cataract Surgery

1. Posterior capsule opacification (PCO) or secondary cataracts: It is the most common of the cataract surgery complications. The posterior capsule experiences secondary opacification because of the differentiation, proliferation and migration of the lens epithelial cells (LECs).
2. Blurry vision: It is the most common cataract surgery recovery complication. The cause behind the blurry or unclear vision is eye swelling. Patients with larger or denser cataracts have the chance to undergo this problem. Ophthalmologists (eye doctors) prescribe anti-inflammatory eye drops to get over this.
3. Allergic reaction to the steroid or antibiotic: Post-surgery, intracameral antibiotics are given. Some patients might be allergic to the antibiotics or the steroids in the medication. 
4. Eye infection: Endophthalmitis is an eye infection that one may face as one of the late complications of cataract surgery. But it’s a rare case. These infections may occur from surgical tools, surgeon’s techniques, etc. You need to take antibiotics as per your doctor’s advice.
5. Wound leaks: A few days after the surgery, a wound leak may appear in the eye because of inadequate closure of the wound. It could cause optic nerve oedema or choroidal effusion. Again, this calls for emergency treatment.  
6. Toxic anterior segment syndrome: It is a severe intraocular inflammation that is generally followed by diffuse corneal oedema. This happens within 1-2 days of anterior segment surgery in cataract operations.

There are certain conditions that can exponentially increase the risk of the cataract complications. Ensure the eye surgeon/doctor is well aware of these risk factors. Then only would they be able to recommend the necessary procedures and precautions for the eyes. These risk factors are:

1. Increasing age
2. Obesity
3. Diabetes
4. Excessive exposure to sunlight
5. Smoking
6. High blood pressure
7. Previous eye injury or inflammation
8. Previous eye surgery

Even though, with the blessing of modern medical science, cataract surgery has become easy, taking certain precautions can go a long way to eliminate possible cataract surgery complications.

Here is a list of such preventions that you can take to ensure you are not facing difficulties:

1. Protect your eyes with a strong shield from dirt and pollutants. So, wear dark glasses after the surgery.
2. You shouldn’t rub your eyes at any cost.
3. Avoid harsh light sources like – flashing lights, TVs, mobiles, desktops, etc.
4. Take extra care of your eyes during bath. Refrain from splashing water on your eyes and soapy water.
5. Make sure to complete your antibiotics and disinfectant eye drops courses.
6. Maintain your home clean and dust free.
7. The most important thing is to follow the doctor’s instructions.

It is difficult to put a timeline on when one should consult a doctor. However, It is recommended to contact your doctor immediately if you experience any of the following symptoms after cataract surgery:

1. Severe eye pain
2. Significant vision loss or changes
3. Increased eye redness or swelling
4. Increased eye discharge
5. Flashes of light or floaters in your vision
6. Nausea or vomiting
7. A fever or other signs of infection
8. Persistent headache
9. Blurred or distorted vision

Prompt diagnosis and treatment of any cataract surgery recovery complications that arise can help to ensure the best possible outcome and protect your vision.

The severity of cataract surgery complications is not similar for every patient. So, there is no reason to panic, and if you feel the symptoms are ‘immediate cataract complications’ after the surgery, get in touch with your doctor as soon as possible to start the treatment. Otherwise, these minor problems can result in major issues and lead to ‘late complications of cataract surgery’. Knowing the risk factors and the preventive measures associated with eye surgery complications will help you better cope with the situation in case you face any difficulty during your treatment process.

At the same time, if you need any assistance regarding your surgery or need a doctor consultation, you can contact the experts of HexaHealth for more guidance. The experts here will guide you through the process and help you find the solutions you are looking for.