Complications of cataract surgery

"I am just wondering when would be a good time to stop worrying about complications."

Right now. My mother used to call that borrowing trouble, and why do it and just make yourself unnecessarily anxious about something that may never happen.

11. PVD (Posterior Vitreous Detachment)

    I experienced this (suddenly seeing a lot of floaters and flashes of light) about 5 months after my surgeries, in one eye only. After seeing my ophthalmologist, he referred me to a retinal specialist to make sure there wasn't anything worse going on, and thankfully there wasn't. It took about 3 months for the floaters to disappear completely, or at least for my brain to make them disappear.

But as maura says, there's no point in worrying about things that haven't happened yet. Just be aware of symptoms, and see a doctor promptly if something does arise.

Based on my memory only, which is not what it used to be!

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Posterior capsule opacification (PCO) - normally only happens months or years after surgery, or never at all, but in some rare cases may happen within days of surgery. Some studies have found that the true necessary YAG rate is as low as 8%

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Retinal detachment - I think this is very rare, but is more frequent in those that are extreme myopes before surgery or laser refraction surgery (extreme long eyes). Retina detachment/tear is also a risk from YAG at about 1/200. IOL damage from the laser is at about 1/100.

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Macular edema - Not sure about his one

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Floaters - This one is quite normal but should reduce as the eye heals

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Dry or itchy eye - Scratchy eye during recovery is common. Dry eye can happen but is more common with laser refraction surgery.

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Infection - It can happen, but is quite a low risk with proper eye drop treatment post surgery.

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Inflammation - Same low risk with proper post surgery steroid drops.

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Lens dislocation or rotation - Some lenses are supposed to be more stable than others, but I believe that is the main reason for the 24 hour post surgery eye exam, to, ensure the lens has not rotated out of position if it is a toric.

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Photopsia or dysphotopsia - Common with MF lenses, and somewhat less common with EDOF. But, all lenses can be somewhat of a risk. Happens more frequently with younger people with larger pupils.

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Glaucoma - It is common for eye pressure to go up after surgery and remain up for a while. In most cases it comes back down again. Overuse of steroid drops may increase the risk of the pressure staying elevated and causing permanent glaucoma.

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Posterior Vitreous Detachment PVD - This is an insidious one. It typically does not happen immediately after surgery, but instead several months later. The study at this link found that there was no increase in PVD rates up to 6 months after surgery, but at 12 months the rate was elevated by a factor of 7.1 times. I got mine at 10 months, and 13 months post surgery. My surgeon was offended when I raised it as an issue. He said it was caused by my age and not surgery. I think he is wrong, and I have the eyes to prove it. This currently is the most annoying outcome of my cataract surgery. But it could be argued that I would have gotten it eventually anyway. Later would have been better. In any case there is not much you can do about it.

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Nature Published: 30 August 2021

Progression of posterior vitreous detachment after cataract surgery

Shunsuke Hayashi, Motoaki Yoshida, Ken Hayashi & Kazuo Tsubota

Thanks all, for the information and the sound advice. It seems PVD was the "insidious", delayed-reaction complication I was curious about. It seems to be less serious than other complications and may be triggered by cataract surgery in roughly 25% of cases, based on a cursory review of the research RonAKA pointed to. I will stop worrying about it. 😉

Age-Related AMD

Long-term studies (5 or more years after cataract surgery) are mixed as to whether AMD is triggered or made worse by cataract surgery. It may depend on age at surgery and elapsed time since surgery.

It may take a year to stop worrying and feel 'natural' with the artificial lenses in my eyes. I have not reached that point yet.

I had very bad Macular Edema about 2 weeks after stopping the drops… all straight lines were crazy zig zags. That was 8 weeks post-op. It was easily treated just by going back on the steroid drops and the symptoms cleared up after 2 weeks back on the drops, We did a MUCH slower taper in order to make sure it didn't come back so in all I was on steroid drops for 4 months.

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I also developed really bad starburst about 5 months post op. As well as PCO. I don't notice any symptoms from the PCO but because the starburts developed later (they were not there AT ALL for the first 5 months) I'm assuming the PCO is causing it. I also have two tiny wrinkles in the bag so maybe that combined with the PCO caused the starburts? I'm hopefully that if I ever get YAG it might fix them.

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As for infection, you're out of the woods in that respect after week 1.

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I love that "borrowed trouble" phrase. I'm going to remember that.