Cataract and Lens Implants

Of all operations commonly performed, Cataract Surgery is one of the most successful and rewarding. However, since it is a major operation, some complications can develop and must be considered before giving consent to have surgery. These include:

Infection: Since the eye is opened for this surgery, a serious internal infection (endophthalmitis) could develop and permanently harm or even destroy the eye and vision. Endophthalmitis can generally be controlled by medications. Sometimes additional surgery is required so that the eye is not completely lost. Vision is inevitably impaired and may even be lost if the eye is badly damaged by the infection. However, under the sterile operating conditions that exist, serious infections are extremely rare.

Haemorrhage: Normal eyes do not tend to bleed (haemorrhage) during surgery, but certain abnormal conditions in some eyes can cause this unusual surgical complication. If it does occur, it can happen in different ways with varying effects. If the bleeding cannot be controlled by the surgeon by any means, vision can be damaged or lost, but the chances of this happening are very remote.

Retinal Detachment: The retina is the delicate light sensitive film at the back of the eye. It must remain attached to the wall of the eye to function normally. Surgery causes a slight disturbance to the internal dynamics of the eye and vitreous gel movement occasionally causes one or more small tears to form in the retina. The patient may then experience e sparks or flashes of light and black spots interfering with his vision. If not given medical attention, these tears can progress to a retinal detachment and loss of vision. But there is little reason to be concerned if treatment is sought as soon as the problem is noticed. Most retinal tears are sealed with a laser or a freezing cryo probe. Even if detachments occur, they too can be treated effectively with surgery.

Cystoid Macular Edema (CME): In this condition a swelling of the central area of the retina called the macula can occur. The macula is responsible for fine central vision. Therefore patients with CME may experience some disturbance in their central vision – blurring and distortion of images. This condition occurs rarely. It is more common following ICCE surgery and hardly ever occurs after successful phacoemulsification. 

Double vision: The administration of anaesthetic can sometimes disturb the delicate muscles that control the co-ordinated movement of the eye. This disturbance can occasionally cause double vision, since the two eyes are not perfectly co-ordinated. This effect, if it does occur, is usually only temporary, but in rare cases, it can continue. If double vision becomes a problem, further surgery can usually reduce or reverse the condition.

“After Cataract”: This misleading term does not mean a return of cataract after surgery. What actually happens is that the transparent posterior capsular support of the IOL becomes translucent and thus does not allow complete transmission of light. The patient’s vision once again becomes slightly hazy as if a cataract is developing again. This is not a serious problem and can be easily remedied by laser treatment using a YAG laser in the out-patient department itself. The laser is able to create a small opening in the posterior capsule. Light once again passes unimpeded through the small opening and vision is restored.

Minor disturbances: Apart from the major complications, there are a few minor disturbances that can occur on a temporary or lasting basis.

• Eyelid droopiness

• Swelling around the eye

• Inflammation or irritation

• Increased dryness of the eye

• Increased light sensitivity

If any of these conditions occur, they are usually treated with medications and clear up within a few days. Sometimes additional surgery or special treatments may be necessary to solve the problem. Occasionally, one or more of these minor disturbances may persist permanently.

How safe is Cataract Surgery  |  Intraocular Lens  |  Patient Care