Cataract surgery, though generally safe, carries certain risks and complications.
Frequently Asked Questions
What are the real risks of cataract surgery — how common are complications?
Modern cataract surgery (phacoemulsification with IOL implant) is one of the safest operations performed; serious complication rates are 1-3% overall. Specific risks: posterior capsular opacification (PCO or 'secondary cataract') affects 20-40% of patients over 5 years and is treated by a quick outpatient YAG laser capsulotomy — not a true complication, just common. Endophthalmitis (intraocular infection) is rare (0.05-0.1%, roughly 1 in 1000-2000 surgeries) but serious — needs urgent vitrectomy and intravitreal antibiotics. Posterior capsule rupture during surgery occurs in 1-3% of cases and is managed by an experienced surgeon, sometimes with vitrectomy. IOL dislocation under 1%. Retinal detachment 0.6-1.7% within 4 years, higher risk in high myopes. Cystoid macular oedema affects 1-3%, treated with anti-inflammatory drops. Up to 40% experience temporary dry eyes for weeks to months post-op. Risk factors include diabetes, high myopia, previous eye surgery, mature or complicated cataract, older age, and complicated anatomy. Choosing an experienced surgeon at a reputed centre significantly improves outcomes.
When should I not get cataract surgery — are there situations to delay?
Situations where surgery is best delayed or avoided: very mild cataract without functional impact — no benefit rushing until visual disability affects daily life (driving, reading, work); uncontrolled diabetes (HbA1c above 8-9%) — worse healing and higher infection risk, so control diabetes first; uncontrolled hypertension — control BP before surgery to reduce intraoperative bleeding; active infection anywhere in the body — postpone until treated; severe dry eye disease — treat first to avoid post-op discomfort; very elderly patients with dementia unable to cooperate — anaesthesia risk needs family discussion; end-stage systemic disease with poor life expectancy; recent stroke or heart attack (wait 3-6 months); anticoagulant medications need review with the surgeon (usually continued, sometimes adjusted); and unrealistic expectations — a standard IOL is fixed-focus, so glasses may still be needed for reading, and refractive surprise is possible. Always get a second opinion for complex cases or if surgery is pushed with unusual urgency.
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