What are the risks and side effects of cataract surgery?

Posterior chamber lens Posterior chamber lens The good news: The Star operation is one of the most frequently performed operations in Germany. Accordingly high are usually the standards. The complication rate is less than 2%.

The most serious, but extremely rare, complication is severe bleeding or infection inside the operated eye. In addition, as with any surgery, there are a few more risks and complications.

A distinction must be made between those that occur during the operation and those that only become noticeable afterwards.

Complications that may occur during surgery:

  • The most dangerous is the mentioned infection with subsequent inflammation of the inside of the eye (endophthalmitis), which can lead to the loss of vision or even of the eye. Luckily it is very rare. Frequency data are from different countries, vary in age and range from 0.02 to 0.15%.
  • It can, especially when removing hard lens cores, come to a fluid accumulation in the interior of the cornea, which is usually gone after a few days.
  • Sometimes the top corneal layer is abraded, which usually heals after 2-3 days.
  • Sometimes a conjunctival hemorrhage occurs, which is harmless. Very rarely, a slight hemorrhage occurs in the anterior chamber of the eye, which is usually absorbed after a few days by the body's own mechanisms.
  • In case of a tear of the posterior lens capsule occasionally the insertion of an anterior chamber lens is required or, very rarely, no lens implantation (more) is possible. If the capsule tears, it can also lead to an incidence of the vitreous body.
  • Rare complications after using an anesthetic injection are bleeding behind the eye, increased blood pressure or drop in blood pressure or palpitations (especially in the heart). Also an allergic reaction against the narcotic can come in individual cases.
  • It is extremely rare that the eye is accidentally stung or the central nervous system causes problems. For safety, therefore, the presence of an anesthetic is required.

Complications that may occur after surgery:

  • Especially younger people occasionally complain about the increased glare sensitivity after the operation.
  • If some of the tarnished lens remains in the eye, a second procedure may be necessary. This happens very rarely.
  • An increase in eye pressure after surgery is rarely observed today and is usually easy to control.
  • The instrumental spread of a narrow pupil, which can not be expanded by medication, can rarely result in a permanently dilated or deformed pupil.
  • Also rare is the replacement of the implanted artificial lens with a new lens, for example due to lens displacement or inaccurate lens power calculation.
  • In addition, there are two complications that are very rare these days: retinal detachment, which requires surgery in a specialized clinic, and transient, usually transient, fluid accumulation in the central retina (macular edema).

Most common "side effect": the after-star

Finally, there is the after-star, which occurs more frequently than the complications mentioned and, in fact, the more frequent and severe the younger one is. This phenomenon is observed months or years after an uncomplicated cataract operation. Its incidence is reported as less than 3% within the first three years after surgery.

In the process, the rear lens capsule, which remains in the eye to support the artificial lens, is clouded by a thin cell layer that grows behind it. This is in itself harmless, but can worsen the vision and make a laser treatment required.

Enlightenment yes, deterrence no

Education is important, good patient rights and medically required. Only those who are well informed can optimally prepare for an intervention and subsequent follow-up. Of course, you should not be put off by a well-founded operation. After all, cataract surgery is still the only proven successful treatment for advanced cataracts and has helped millions of people regain good vision and a better quality of life.

Author: Dr. Hubertus Glaser