Cataract surgery has evolved into a very safe, effective and minimally invasive procedure. Despite the improved safety of this procedure, complications can rarely occur either during the procedure or afterwards.
Problems During Cataract Surgery
The natural lens inside the eye is suspended in place by a collection of connective tissue called zonules. These zonules are similar to the springs that hold a trampoline in place. In addition, the lens is enveloped by a clear bag called the capsular bag. At the time of cataract surgery, the capsular bag is opened, the natural lens material is removed and the artificial lens is placed inside this capsular bag. Sometimes at the time of cataract surgery, all of the lens material can’t be removed either from a defect in the zonules or capsular bag. Lens material may fall to the posterior portion of the eye and the artificial intraocular lens (IOL) may not be placed depending on the amount of support left. If this happens, it is possible that a pars plana vitrectomy may need to be performed to remove lens material from the vitreous cavity.
The normal suspension architecture of the natural lens inside the eye might be abnormal due to several reasons including a connective-tissue abnormality called pseudoexfoliation syndrome or previous trauma. If there is not enough natural support for an artificial lens to be placed inside the eye, then a new lens may need to be stitched to part of the eye to hold it in place (scleral fixated IOL or iris fixated IOL), or lens placed in the anterior portion of the eye (ACIOL). This may need to occur along with a pars plana vitrectomy.
Problems After Cataract Surgery
Several weeks after cataract surgery, swelling can occur in the macula (called cystoid macular edema), causing blurry vision. This can be treated with drops of anti-inflammatory medicines but less commonly sometimes needs stronger treatments.
Other more rare complications associated with cataract surgery include bleeding (choroidal hemorrhage) and infection (endophthalmitis). Both of these conditions are very serious and threaten the viability of the eye in the long term. These problems are treated with medical and/or surgical interventions.