Surgery for cataracts is a fairly uncomplicated, standard procedure these days. Cataract eye surgery problems following the procedure are relatively rare, but they do sometimes occur. Problems may include bleeding, infection, inflammation (pain, redness, swelling), double vision, loss of vision, and high or low eye pressure. Given timely medical attention, such problems can usually be successfully treated.
There are two forms of cataract surgery. Your doctor can give you the details concerning the differences and help establish which is better for you.
1. Phacoemulsification. A small incision is made on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. Your doctor inserts a tiny probe into the eye. This gadget emits ultrasound waves which wil soften and break up the lens so that it can be removed by suction. Most cataract surgery today is phacoemulsification, also known as “small incision cataract surgery.”
2. Extracapsular surgery. Your doctor makes a longer incision on the side of the cornea and removes the cloudy core of the lens in one piece. The remainder of the lens is removed by suction.
After your original optical lens has been removed, it typically is replaced by an artificial lens, referred to as an intraocular lens (IOL).
The IOL is a clear, plastic lens requiring no care; it becomes a permanent part of your eye. Light is focused clearly by the IOL onto the retina, improving your vision. You will not feel or see the new lens.
From time to time, the eye tissue enclosing the intraocular lens turns cloudy and can blur your vision, a condition called an after-cataract. After-cataracts can arise months or years after the original cataract surgery.
A laser is used to treat an after-cataract. Your doctor focuses the laser and makes a minute hole in the eye tissue in back of the lens to allow light to pass through. This procedure is called a YAG Laser Capsulotomy. It is done on an outpatient basis, and is painless, rarely resulting in increased eye pressure or other eye problems. As a preventative measure, your doctor may administer eyedrops to lower your eye pressure before or after the procedure.
Posterior Capsular Tear
A posterior capsular tear may be a problem during cataract eye surgery. This is a rupture of the posterior capsule of the natural lens. Surgical alleviation may involve an anterior vitrectomy and, infrequently, alternative planning for implantion of the intraocular lens, either in the ciliary sulcus, in the anterior chamber (in front of the iris), or, less commonly, sutured to the sclera.
Some mild discomfort and itching and are to be expected after cataract eye surgery. Fluid discharge is also common. Your eye may be sensitive to light and touch. Should you experience any discomfort, your doctor can suggest the proper treatment. After a day or two, moderate discomfort should fade away. In the majority of cases, healing will be complete within eight weeks; your doctor will schedule exams to follow up on your progress.
A small number of patients who have undergone cataract eye surgery find their vision is improved but also subtly changed. The surgical removal of a cataract and implantation of an intraocular lens enhances their visual acuity, but introduces changes that were never there prior to the surgery. Symptoms reported vary widely. Some patients speak of ghosting, halos, sudden flashes of light, and slight overlapping of images. Dysphotopsia is the medical term for this phenomenon
Other possible but more infrequent complications include edema of the cornea with no connected cloudy vision, known as pseudophakic bullous keratopathy, displacement or dislocation of the intraocular lens implant, swelling or edema of the central retina (cystoid macular edema), and unanticipated high refractive error.