Understand Cataract Surgery Side Effects & Complications

Cataract surgery is considered to be one of the safest procedures. 

The risk of serious complications from cataract surgery is estimated by the NHS to be around 1 in 50 cases. A quarter of these are due to surgical complications.

For most patients, cataract surgery is easy, fast, and free from issues. After surgery, vision is better and most people recover quickly.

By understanding potential side effects and risks, you can feel prepared for the surgery. If you do encounter a complication, you’ll know what to do and whom to contact.

Most Common Side Effects or Complications of Cataract Surgery

These are the most common side effects of cataract surgery:

• Dizziness, grogginess, and nauseous: You may feel a little sick to your stomach, groggy, nauseous, or disoriented after surgery. According to the American Academy of Ophthalmology, this can be the result of surgical anesthesia. This side effect may last a day or two after your surgery.
  
  Experts recommend staying hydrated and eating bland foods to manage these symptoms. 
• Sensitivity to light: Many patients find that they are sensitive to light after surgery. This is common for the first couple days after surgery. Wear sunglasses to manage light sensitivity.
• Unclear or blurry vision: Your vision may seem a little blurry or unclear in the days after surgery. This is considered normal and should clear within a couple days.
• Dry, itchy or gritty feeling in the eyes: It’s common for the eyes to feel irritated after surgery. For most people, prescribed eye drops relieve the itchiness. Talk to your surgeon about the dosing schedule for any prescribed drops.
• Redness and swelling: After cataract surgery, a little redness or swelling is completely normal. This is often treated with eye drops or other prescriptions.
• Seeing dots, spots, and light flashes: Floaters look like floating dots or spots in your vision. There’s no direct treatment, but they usually fade over some time.
  
  Surgery may cause changes in the vitreous, creating an illusion of flashes of light, spider webs, and clouds in your vision. These symptoms often improve within a few months and don’t require further surgery.
• Temporary droopy eyelid: After surgery, droopy eyelid or ptosis is a common complication, occurring in about 10 percent of cases. It usually goes away on its own. If it persists for more than six months, it may require corrective surgery, known as eyelid surgery or blepharoplasty.

Talk to your doctor if you experience any of these more common side effects. They can offer advice on your specific situation. 

If you feel extreme pain, headache, or severe pressure around the eye, seek emergency medical care. 

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Less Common Side Effects & Complications of Cataract Surgery

These issues are rare but possible with cataract surgery.

• Infection: Though uncommon, infection can occur, and this can create pain, light sensitivity, and vision problems. Signs of infection include swelling, redness, and a yellow, green, or milky discharge.
  
  If you suspect infection, call your doctor right away. They may give you an antibiotic shot. In very severe and rare cases, a doctor may remove the clear gel at the center of the eye, called the vitreous, to remove the infection.
• Secondary cataract: After surgery, it’s possible to develop a secondary cataract or posterior capsular opacification (PCO). Cloudy vision is the main symptom, and this results from clouding of the posterior capsule.
  
  To fix this condition, your ophthalmologist can perform a quick laser surgery, YAG laser capsulotomy. This procedure allows light to pass through the lens so vision is clear.
• Corneal swelling: After surgery, the front part of the eye or cornea can become swollen. This is usually temporary and improves in days or weeks. Your doctor may recommend treating this condition with eye drops.

Remember that these side effects are not common. More than 99 percent of people who have cataract surgery have no complications. 

Very Rare Side Effects of Cataract Surgery

These severe side effects of cataract surgery are extremely rare:

• Retinal detachment: After surgery, the retina may pull away from the back of the eye. This condition is often described as feeling as if a curtain has fallen over the eye. The patient may perceive flashes of light or new floating spots in the visual field.
  
  This can cause vision loss, so see your ophthalmologist right away if you experience any symptoms. 
• Toxic anterior segment syndrome (TASS): This condition occurs at the back of the eye, and it is a rare complication of anterior segment surgery.
  
  It’s caused by exposure to contaminated material during surgery. It can often be cured by applying steroid ointments or creams to the eyes or taking oral steroids. The inflammation may still cause permanent damage to eyesight, so it’s important to seek medical attention immediately.
• Lens fragments: During surgery, some bits of the cloudy lens may fall into your eye and be left behind. Tiny bits generally don’t pose a problem, but larger portions can be problematic.
  
  If this occurs, you may need surgery to remove the fragments and prevent swelling.
• Blurry vision from retinal fluid buildup: After surgery, blood vessels can leak in the retina, causing blurred vision. This fluid buildup is usually treated with eye drops and heals within weeks or months.
  
  In advanced cases, your doctor may recommend a steroid shot behind the eye or surgery to correct the problem. 
• Double vision from dislocated intraocular lens (IOL): During cataract surgery, your doctor will put an artificial lens (IOL) in your eye. If it slips out of place, you may experience double vision or blurring. You may need surgery to correct the placement and prevent complications, such as bleeding and swelling.
• Uncomfortable eye pressure: It’s possible to feel an increase in pressure in the eye following surgery. The medical term for this is ocular hypertension. It can damage your vision, so it should be treated promptly with eye drops, pills, or shots.
  
  This condition can also result from swelling, bleeding, or lens fragments, so have your doctor evaluate your condition.
• Visual effects: Dysphotopsia is a condition that creates visual effects, such as seeing a curved shadow at the edge of your vision or seeing halos, bursts, streaks, and flashes of light. This often goes away on its own, so most doctors recommend waiting to see if it gets better.

These rare complications may be due to physician error, exposure to bacteria or contaminants, or fluid buildup during surgery. 

Again, these complications are exceedingly rare. Cataract surgery is widely viewed as very safe with little potential for complications. 

How to Treat Side Effects From Cataract Surgery

Contact a medical professional if you are experiencing discomfort, pain, or sudden onset of any symptoms following cataract surgery. 

Depending on the specific issue, your doctor may prescribe eye drops, injections, or oral medication. These can prevent infection, control eye pressure, and reduce inflammation.

In addition, certain physical adjustments can provide relief. It’s a good idea to wear:

• An eye patch in the days following surgery if the eye is sensitive.
• Sunglasses when outside or in bright indoor lighting.
• A protective shield on the day of surgery.
• A protective shield during sleep to prevent rubbing or scratching the eye while asleep.

Many side effects are treated with surgical procedures. Talk with your physician about surgical options if symptoms persist.

When to Call a Doctor

If you notice a sudden increase in your vision, such as floaters or flashes, contact your eye care professional right away. This could be signs of retinal detachment, which is a medical emergency. 

If your doctor is not available, go to an emergency service or hospital. While retinal detachment is not painful, early treatment can prevent permanent loss of vision.

Experts at the American Academy of Ophthalmology advise contacting your doctor immediately if you experience these symptoms:

• Loss of vision
• Persistent pain despite taking prescribed pain medication
• Increase in eye redness
• Swelling of the eyelid
• Multiple new floaters or light flashes

How to Prevent Side Effects & Complications

Good hygiene can help to keep bacteria and debris away from your eye while it’s healing. Follow your doctor’s postsurgical instructions closely.

• Wash your hands frequently, particularly before touching your face.
• Wear an eye shield or eyeglasses to protect your eye while it’s healing.
• Avoid rubbing or pressing on your eye.
• Do not bend at the waist to pick up objects; bend from your knees.
• Do not lift heavy objects for a few weeks.
• Contact your doctor immediately if you suddenly experience symptoms or if symptoms don’t improve.
• See your doctor for all scheduled follow-up exams.

Cataract Surgery Complications FAQs

What are some side effects of cataract surgery?

According to the American Academy of Ophthalmology, blurred vision, vision loss, and sensitivity to light are some of the side effects of surgery. These most commonly resolve in days or weeks. Serious complications may result in an estimated 1 in 50 cases.

What is the most common complication of cataract surgery?

After cataract surgery, itching and mild discomfort are normal side effects. You may experience some fluid discharge, and your eye may be sensitive to light as well as touch. This moderate discomfort should resolve after one or two days. 

How long does it take for my vision to stabilize after surgery?

In most cases, healing will be complete within eight weeks. While specific healing time varies across individuals, your doctor can give you a personalized estimate.

References

1. Cataracts. John Hopkins Medical Center.

2. Cataract Surgery. NHS.

3. 10 Cataract Surgery Side Effects, and How to Cope. (May 2021). American Academy of Ophthalmology (AAO).

4. Cataract Surgery: Risks, Recovery, and Costs. (September 2021). American Academy of Ophthalmology (AAO).

5. Eyelid Surgery: Blepharoplasty. American Society of Plastic Surgeons.

6. Vitreous. (March 2016). American Academy of Ophthalmology (AAO).

7. What Is Ptosis? (February 2022). American Academy of Ophthalmology (AAO).

8. Cataract Surgery: Risks, Recovery, Costs. (September 2021). American Academy of Ophthalmology (AAO).

9. Knowing When It’s Time for Cataract Surgery. (September 2016). University of Michigan.

10. Cataract. (September 2015). NIH.

11. Toxic Anterior Segment Syndrome – An Updated Review. (October 2018). BMC Ophthalmology.

12. The Melaka Hospital Cataract Complications Study Analysis of 12,992 Eyes. (January 2017). Indian Journal of Ophthalmology.

13. Early and Late Complication of Cataract Surgery: Observational Study. (February 2018). International Journal of Scientific Research.