How safe is cataract surgery?
Cataract surgery is a remarkably successful operation. The vast majority of people achieve an excellent result but most will still need to wear glasses at least some of the time.
However, as in any surgery, there is always a risk of complications. In cataract surgery, the risk is small and complications in most cases can be treated effectively. In some cases, further surgery may be needed.
Overall, there is approximately a 1 in 400 risk of a complication that would permanently impair your vision and a 1 in 1000 risk of severe complication such as infection that could lead to blindness.
Some possible complications during the operation
- Tearing of the back part of the lens capsule which may require removal of some of the gel (vitreous) from the inside of the eye. This may sometimes result in reduced vision.
- Loss of all or part of the cataract into the back of the eye during the operation. This may require a further operation to remove the rest of the cataract.
- Bleeding inside the eye during the operation. This may result in reduced vision.
Some possible complications after the operation
- Bruising of the eye or eyelids - High pressure inside the eye which may need treatment with drops or tablets
- Haziness of the cornea (the clear front of the eye). This usually clears over several days or weeks.
- Unexpected long- or short- sightedness. In most cases this only requires a change of glasses. However, if there is a big difference in glasses prescription between your eyes it may be necessary to change the lens implant with another operation or to wear a contact lens.
- Swelling of the centre of the retina at the back of the eye (macular oedema). This is usually treated with extra drops or tablets but can result in reduced vision in some cases.
- Detached retina. This requires laser treatment or surgery and can lead to loss of sight
- Infection of the eye (endophthalmitis). This is a rare complication but can lead to loss of sight or even loss of the eye.
- Allergy to the medications used. It is important that you have discussed the risks of surgery to your satisfaction before the operation. The doctor who first sees you will generally discuss this but please ask the doctor or nurse if you have any further queries.
Will I need to wear glasses after cataract surgery?
Most people will need to wear glasses for reading, distance or both after cataract surgery.
Before the operation the nurses in the pre-assessment clinic will perform measurements of your eyes (biometry) to determine the strength (power) of lens implant to put into your eye.
The strength of the lens implant can be chosen to leave you either short-sighted (focused for near), long-sighted (focused for distance) or neutral (you would still need glasses for reading).
The surgeon will often choose the strength of lens implant to leave you with a similar glasses prescription in both eyes.
However, sometimes a surgeon may plan to make your eye much less long or short-sighted than it was before so that you do not need to wear such strong glasses. In this case, the glasses prescription will be different between your two eyes until you have cataract surgery on the other eye and they can be matched up. You surgeon would discuss this with you before the operation.
The biometry measurements are not accurate in all patients and some patients may have a more long or short sighted eye than predicted by the measurements. In most cases a pair of glasses will correct any small differences in a long or short-sightedness between your eyes.
You will be advised about your new glasses at one of your clinic visits after the operation. You may be able to get your new glasses as soon as 2-3 weeks after the operation, but in some cases it may be necessary to wait as long as 2-3 months, when you finally see how much your sight has been improved by your cataract operation.
Can a cataract come back again?
A cataract cannot form again after cataract surgery. However, in some patients the back part of the lens capsule which has been left in place to support the implant can become cloudy.
This may come on gradually over months or years after the cataract operation and is called 'posterior capsule opacification.' You may also hear this called a 'secondary cataract'.
Your optician will advise you if you have posterior capsule opacification which is affecting your sight. If you wish, your own doctor can then refer you back to the hospital where the eye specialist will discuss whether treatment is necessary.
This is easily done in the outpatient department using a special laser, which makes a small opening in the cloudy lens capsule to clear the centre of your vision and improve your eyesight.
The staff on the Eye Unit hope that your stay will be a comfortable one and that your sight will be greatly improved by your cataract operation. If you have any complaints or suggestions as to how we can improve the service, please let one of the nursing or medical staff know.
The TYNESIGHT fund supports research and has enabled the purchase of some of the equipment currently in use in the operating theatre and in the Eye Outpatient Department. If you wish to make a donation please ask a member of staff for the TYNESIGHT leaflet available on the wards and in the Outpatient Department.