What are the risks and benefits of cataract surgery?

What are the benefits of cataract surgery?

Despite the cataract surgery risks we’ll cover later on, the procedure carries a high success rate. Some of the advantages of cataract surgery include:

• Clarity of vision – A cataract forms when the protein in your eye accumulates on the lens. These deposits cloud the lens and cause foggy and blurry vision. Cataract surgery fixes this, replacing the old lens with a new artificial one. The new lens provides clearer, crisper vision.
• Colour – Cataracts can cause the lens in your eye to become yellow or brownish. This can cause everything to look faded. Cataract surgery can help fix this, with many patients reporting seeing much brighter colours than before.
• Fewer injuries – Eye problems contribute to falls which are a common cause of injury and death among older adults. Recovery can potentially last a long time which can lead to social isolation and depression. After cataract surgery, patients are less likely to need varifocal glasses. In turn, this means they’re much less likely to suffer falls.

If you suspect you’re suffering from the signs you need cataract surgery, please don’t hesitate to get in touch.

The benefits of early cataract surgery

NICE guidance states that any symptom generated by a cataract is sufficient for cataract surgery. Your surgeon will listen to your symptoms and discuss the risks and benefits of cataract surgery with you. One of the benefits of private cataract surgery is the reduced waiting list.

If the surgery is delayed the cataracts harden and the surgery can become more difficult.

Is cataract surgery high risk?

In the vast majority of cases the operation is successful and vision improves immediately. In a small number of cases complications occur but these are all uncommon and can usually be treated. However, on rare occasions they are serious enough to cause permanent visual problems.

Ongoing problems after cataract surgery may be related to pre-existing eye problems like glaucoma and macular degeneration.

Cataract risk factors

Surgical complications include:

• The iris could be damaged by the ultrasound probe (risk 1 in 50 patients)
• Corneal abrasion: Accidental scratching of the eye during the operation. The eye can feel gritty, post-surgery but generally heals rapidly (risk 1:100)
• Posterior capsule rupture (tearing of the lens capsule), leading to vitreous loss (the vitreous is a jelly-like substance located between the lens and the retina). This may cause vision problems or loss of a lens fragment into the back of the eye. This may require further surgery (risk 1:100)
• The lens could move from its intended position (risk 1:400)
• Severe bleeding inside the eye during surgery (risk 1:1,000)
• Posterior capsule opacification (PCO) is one of the most common complications after surgery. PCO is reported to occur in 20%–40% of patients between two and five years after surgery.

Which are the risks of cataract surgery?

Some complications of cataract surgery may involve:

• Damage to the back part of the lens capsule – this can lead to a disturbance of the gel (Vitreous) that is inside. In turn, this can cause reduced vision. All or part of the cataract may be lost into the back of the eye, which may require further surgery
• Endophthalmitis (Infection) – This can occur inside the eye and is a serious infection. The treatment involves further operations to administer antibiotics into the eye. Around half of endophthalmitis patients unfortunately do not recover their sight
• Bleeding – this can occur within the eye during surgery. In extreme cases, it can result in loss of sight
• Eye feeling dry and gritty – This can be relieved with dry eye drops bought at any pharmacy.

Other risks involved in the surgery and after-care process include:

• Inflammation
• Swelling
• Drooping eyelid
• Dislocation of artificial lens
• Retinal detachment
• Glaucoma
• Secondary cataract
• Loss of vision

Risks of cataract surgery in the elderly

The most common reason for the risk of cataracts is growing older when natural changes within the lens occur. Most people over the age of 65 have some changes in their lens and the majority will develop a cataract in time.

What are the cataract operation risks?

As with any eye surgery, there is a small risk of infection, blurred vision and detached retina. There is a very small risk, around one in 1,000, of permanent sight loss in the treated eye.

What is the most common complication after cataract surgery?

Potential complications include:

• Blurred vision due to swelling of the retina. This can be treated with drops (risk 1 in 20 patients)
• Pain – this is usually mild and can often be treated with a pain killer such as paracetamol. If you experience severe pain, this may indicate an infection or inflammation. We advise you to urgently contact your eye-care team (risk 1:50)
• Allergic reaction to the drops (risk 1:100)
• Drooping of your eyelid(s) (risk 1:100)
• High pressure in the eye (risk 1:100)
• Clouding of the cornea (risk 1:100)
• Retinal detachment – this can occur over the subsequent five years. If the retina detaches you may notice a series of flashes followed by a shadow that creeps across the vision. Action is needed to save your vision and you should seek urgent advice (risk 1:250)
• Infection of the eye. Despite the care we take in theatre and the antibiotics given to you following surgery, infection is still a risk. If your eye becomes painful and blurred, you should contact the hospital straight away (risk 1:1,000).

What percentage of cataract surgeries have complications?

Cataract surgery is a common procedure carried with a complication rate of roughly 2%.

Is cataract surgery worth the risk?

If left untreated cataracts can interfere with everyday life including work, driving and hobbies. Cataract surgery is a safe procedure with a low complication rate that can improve vision and quality of life.

Further details about cataract guidance and cataracts and eye health is available on the Practice Plus Group website.

What is the success rate of cataract surgery?

Cataract surgery is a 98% complication free operation.

How can I reduce the chance of risks and complications?

To further reduce the risk following cataract surgery you should:

• Take it easy at home for a few days following surgery
• Avoid strenuous effort for about one month, including lifting heavy things
• Avoid rubbing the eye. A scratchy or gritty eye is normal after cataract surgery
• Wear dark glasses for a few days as your eye(s) will be more sensitive to light
• Avoid getting the eye wet
• Take paracetamol or your usual painkillers if experiencing any discomfort such as a headache or mild pain.

When selecting a healthcare provider, check their quality rating from the Care Quality Commission (CQC). A ‘Good’ or ‘Outstanding’ CQC rating will show the provider to be safe and effective when providing treatment. For advice pre or post surgery, discuss with your eye doctor.