Complications After Cataract Surgery
A cataract is one of the blinding diseases of the world, ranking about 40% of world blindness. The prevalence of cataract increases with age, however other causes such as sunlight exposure, alcohol, dehydration, diabetes mellitus, and use of certain medications can accelerate the process.
One of the marked pathogeneses of cataract is the denaturation of protein by oxidation. Metabolic disturbances like hyperglycemia, hyper uremia, toxins and loss of anti-oxidants, failure of active transport, and loss of osmotic balance are also related to the pathogenesis. There is no proven medical treatment of cataract. Surgical removal of the cataract is one of the safe and effective methods.
Cataract surgery involves the removal of the cataractous lens and replacement with an artificial intraocular lens. Like many other surgical procedures, cataract surgery may have some complications, among which blurry vision is the commonest symptom. The article will explain the normal and abnormal causes of blurred vision after surgery.
Is it normal to have blurred vision after cataract surgery?
Yes, it is totally normal to have blurred vision after cataract surgery. Not all patients respond equally to the same procedure. The eye makes an adjustment to the newly implanted intraocular lens and takes time. However, if the blurring continuous for a long time and is associated with other conditions like watering, pain, and redness, then medical help should be seek immediately.
What are the causes of blurred vision?
Inflammation:
Inflammation is one of the normal immune responses to the manipulation done during eye surgery. You may develop blurred vision along with swelling of lids, watering, and mild pain. It will subside slowly with medication prescribed by a doctor. In case of prolong the duration of symptoms, help should be taken from the health care provider.
Toxic anterior segment syndrome (TASS):
It is non-infection inflammation of the eye structures due to the entry of toxic substances in the anterior chamber during surgery. It can cause permanent damage. The onset of TASS is 12-24hr postoperatively, distinguishing it from endophthalmitis, occurring after 24 hr of surgery.
Treatment involves topical steroids.
Corneal edema:
Corneal edema is caused due to prolonged duration of surgery or excessive manipulation during the procedure. It will subside with time, and the doctor will prescribe specific drugs at the end of the procedure.
Wound leak:
It is another cause of blurred vision in post-operative cataract surgery. It results due to poor wound construction and improper suturing technique.
Iris prolapse:
Due to poor wound construction, a part of the iris may protrude out from the cornea labeled as iris prolapse. Surgical intervention may be needed.
Endophthalmitis:
It is one of the dreadful causes of blurred vision in post-operative patients. Its onset is 1 to 7 days post-operatively. Endophthalmitis is suspected when there is worsening pain, reducing vision, increasing inflammation, and lid swelling. The outcome of vision depends on the extent of vision on initial examination.
Posterior capsule opacification:
Posterior capsule opacification is a phenomenon occurring in almost 50% of the patients and it is universal in the pediatric age group. Symptoms may include reduced vision or diplopia. Treatment involves YAG posterior capsulotomy at an average of 6 months post-operatively.
CMO:
Cystoid macular edema is a common complication in diabetes mellitus. It is associated with decreased vision post-operatively. It may start immediately after the surgery or can take 3-4 months to develop.
Treatment involves topical NSAIDs.
Retained lens fragment:
Some of the fragments of the lens matter may remain in the anterior chamber post-operatively, giving symptoms of blurred vision, watering, and pain.
Treatment involves topical medications.
Retinal detachment:
Complications during cataract surgery such as posterior capsular rupture and vitreous loss can cause retinal detachment. The management involves a surgical procedure.
Corneal decompensation:
It is a painful condition associated with blurred vision, photophobia, and watering. Due to decompensated cornea bullae are formed in the cornea and every time it ruptures, a painful episode is experienced by the patient.
Droopy eyelid:
Some patients may develop drooping of eyelids after cataract surgery. During the surgery, the eye speculum used for opening the eye may cause dehiscence of the levator muscles. It takes some time for the levator muscle to normalize.
Photopsia/ glare:
After cataract surgery complication, photopsia is a common complication. The patient slowly becomes habitual with the condition and as posterior capsular opacification occurs.
When to immediately seek medical help?
some of the alarming condition includes the following
- Out of proportion pain.
- Sudden loss of vision.
- Gradually worsening vision.
- Associated discharge and hyperemia.
- Sudden flashes of light.
FAQs
What is normal after cataract surgery?
After the cataract surgery, your vision will slowly improve. The patient should avoid undue expectations of a sudden improvement of eyesight post-surgery.
Can you have cataract surgery twice?
No, cataract surgery is performed only once. The opacified natural lens is replaced with an artificial intraocular lens. Second surgery might be required for any complication that might have occurred during the surgery or post-surgery.
Can the cornea be damaged during cataract surgery?
All cataract surgeries do not end up with corneal damage. In certain circumstances, the endothelium layer of the cornea is damaged during the surgery and may lead to corneal decompensation post-surgically.
Can lens implant be redone ?
The reimplantation of the intraocular lens is a very rare procedure. However, it can be performed if there is any problem with the previously implanted lens.
What happens if lens moves after cataract surgery ?
The implanted lens may be dislocated or subluxated into the anterior chamber and can render the patient functionally impaired, or it can drop back into the vitreous. For either case, surgical procedures are followed.
What happens if you lift something heavy after cataract surgery ?
Lifting heavy weight after the cataract surgery may lead to increased intraocular pressure, which is a damaging condition in post-operative patients.
What is subluxation of lens ?
It is the displacement of the lens from its normal anatomical position. Subluxation is a partial displacement from the primary position while luxation is the complete displacement of the lens.
