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Complications of Cataract Surgery


Glaucoma or a buildup of pressure within the eye (intraocular pressure) also sometimes occurs after cataract surgery. If your eye pressure remains high, you may need additional treatment such as eye drops, a laser procedure, pills or additional surgery.

Far more rarely, you might experience problems such as a decentered intraocular lens that might need to be repositioned or replaced in a second surgery. Various complications, ranging from minor to serious, also can take place as a direct result of the surgical procedure, including tearing of the posterior capsule holding the intraocular lens in place.

Retinal detachments also are possible in up to 3.6 percent of people following cataract surgery (Ophthalmology reference book, 2004), particularly if you have unusually long eyes associated with nearsightedness. Some eye surgeons dispute this direct association with cataract surgery (EyeWorld, November 2004), because highly nearsighted people already are at risk of retinal detachments with or without cataract surgery.

If you notice fading vision similar to a curtain moving across your field of view or flashes of light, immediately seek medical help for a possible retinal detachment. Retinas can frequently be reattached and vision restored, but only if action is taken promptly.

Endophthalmitis causing widespread inflammation or infection of the eye can be a serious side effect of cataract surgery that can lead to permanent vision loss and even blindness. Various studies indicate that endophthalmitis occurs in about one out of every thousand cataract surgeries. Endophthalmitis also is more likely to be seen in people with compromised immune systems associated with conditions such as diabetes (Ophthalmology Clinics of North America, December 2006).
However, even serious cataract surgery complications often can be resolved with appropriate follow-up treatments.

Cataract Surgery Outcomes
A comprehensive study reported in Archives of Ophthalmology in 1994 noted that 95.5 percent of healthy eyes achieved 20/40 uncorrected vision (legally acceptable for driving) or better outcomes following cataract surgery. Of the more than 17,000 eyes evaluated, fewer than 2 percent had sight-threatening complications.

Remember that sight-threatening complications often are associated with individuals who already have poor underlying health affecting how their eyes heal. Also, some individuals have complications because their cataracts are far more advanced or "hardened" at the time of surgery, making them difficult to remove.

A Swedish study published in the British Journal of Ophthalmology in November 1999 found that self-reported outcomes among people who had undergone cataract surgery were less satisfactory when other eye problems were present. Younger individuals undergoing cataract surgery reported the highest satisfaction levels.
The British journal also reported study results in December 2000 indicating that people in their 60s undergoing cataract surgery were 4.6 percent more likely to achieve 20/40 uncorrected vision or better than people in their 80s




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