Tuesday, November 22, 2011

Complications from Cataract Surgery

Question: I seem to have a lot of complications from my cataract surgery. I had cataract surgery on my right on July 1, 2011 with a lens implant to correct my far and near vision. I have been back to the eye doctor 8 times complaining that my vision has not improved and actually it has worsened. He used the laser to remove the part of the capsule and that has not helped. Now I am seeing floaters and funny shapes in my vision. I went to see the doctor this past Friday and he says he noticed that there is some swelling of the Retina and he has given me some new drops and says come back in a month. Why is it that after spending $7000 I can't see? Should I be looking for another doctor?
Answer: While Cataract Surgery and Lens Implantation are among the most frequent and most successful types of eye surgery one can have, there is always the risk of side effects and complications that can result from the surgery itself or simply just from the condition and health of the eye-unrelated to the surgery. Although it is impossible to know exactly what is going on with your eyes and vision you are describing some things that we know can sometimes occur. First, you describe the need to be treated with a laser to "remove" part of the lens capsule. In as many as 30% of the people having routine Cataract Surgery, the posterior lens capsule-normally left intact to support the Lens Implant-does become cloudy or opacified. This is treated with a procedure called a YAG Laser Capsulotomy in which an opening in placed in the capsule with a laser in order to allow light to readily pass through to the back of the eye. While not every patient requires this, it is not uncommon and represents one of the most common complications of Cataract Surgery. However, the YAG Laser treatment is quite effective in restoring vision in almost every instance of posterior capsular opacification. The fact that you are experiencing floaters may or may not be related to the Cataract Surgery. You are possibly describing a vitreous detachment that may have occurred spontaneously or in conjunction with the Cataract removal.

IF you have a vitreous detachment that is causing the floaters they will self limit over time and will likely no longer disturb your vision. But it takes time and your Cataract Surgeon will want to be sure that there are no associated tears in the Retina contributing to the floaters. Another complication that are possibly describing is the presence of Cystoid Macular Edema which is a painless swelling of the Retina that can cause blurred vision and distortion. it is thought to be due to post operative inflammation and may occur in about 1% of the patients having Cataract Surgery. While the pre and post operative drops that are normally prescribed are usually sufficient to manage the inflammation, sometimes they require an additional or alternative more powerful anti-inflammatory eye drop to reduce the inflammation and the swelling. Although it is difficult for you to be the recipient of what seems like so many complications, they are all familiar and known complications of Cataract Surgery-albeit unusual. However, they are also pretty much manageable over time with careful observation, testing and treatment. That said, it is never inappropriate to get a second opinion in order to confirm the diagnosis and treatment as well as the prognosis. If it would make you more comfortable you should either find the best Cataract Surgeon in your area or even find a Retinal Specialist who can give you an opinion regarding your individual situation.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

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