All About Vision With Dr Kondrot

All About Vision With Dr Kondrot

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All About Vision With Dr Kondrot
All About Vision With Dr Kondrot
⚠️ What Can Go Wrong After Cataract Surgery?

⚠️ What Can Go Wrong After Cataract Surgery?

Jun 19, 2025
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All About Vision With Dr Kondrot
All About Vision With Dr Kondrot
⚠️ What Can Go Wrong After Cataract Surgery?
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Understanding the Possible Complications—and How to Protect Your Vision
By Dr. Edward Kondrot | All About Vision

Please hit the ❤️ at the top or bottom of this email to help others discover All About Vision With Dr. Kondrot. Your subscription directly supports my ongoing humanitarian work—delivering free eye surgeries and care where it's needed most.

🧠 Story at a Glance

  • Cataract surgery is one of the safest and most common surgeries worldwide.

  • Still, as with any surgery, complications can happen—some minor, some more serious.

  • Common issues include posterior capsule opacification (PCO), inflammation, increased eye pressure, or infection.

  • Most complications are treatable, especially when identified early.

  • Understanding the risks can help you know what to watch for—and how to respond quickly.

👁️ The Good News First

Cataract surgery has a high success rate, with over 95% of patients experiencing improved vision afterward, according to the American Academy of Ophthalmology.

That said, it’s still surgery—and your eyes are delicate. So let’s walk through what might go wrong and what you can do about it.

🔍 Possible Cataract Surgery Complications

1. Posterior Capsule Opacification (PCO)

  • Sometimes called a "secondary cataract"

  • Happens when cells grow behind the lens implant, causing blurred vision

  • May appear weeks, months, or even years after surgery

  • Solution: Treated with a quick, painless laser procedure (YAG capsulotomy)

2. Infection (Endophthalmitis)

  • A rare but serious complication

  • Symptoms include pain, redness, vision loss, or discharge

  • Occurs in 0.04–0.2% of surgeries

  • Solution: Requires immediate treatment with antibiotics, sometimes surgery

3. Inflammation

  • Mild inflammation is normal, but sometimes it becomes persistent or excessive

  • May cause floaters, light sensitivity, or discomfort

  • Solution: Treated with anti-inflammatory eye drops or oral medications

4. Increased Eye Pressure (Ocular Hypertension or Glaucoma Flare)

  • Some patients experience a temporary or sustained rise in eye pressure

  • Temporary IOP spikes are common and often resolve. Persistent elevation may lead to glaucoma.

  • This may occur due to retained viscoelastic, steroid response, or preexisting glaucoma

  • Solution: Eye pressure-lowering drops or additional treatment and regular monitoring

5. Retinal Detachment

  • Very rare but more likely in patients who are highly nearsighted or have trauma history

  • Can occur weeks to months after surgery

  • Warning signs: Sudden floaters, light flashes, shadow or curtain in vision

  • Solution: Urgent retinal surgery

6. Cystoid Macular Edema (CME)

  • Swelling in the central retina (macula)

  • Can cause blurry or distorted central vision

  • Solution: Anti-inflammatory drops or injections, often temporary

7. Dislocated Intraocular Lens (IOL)

  • The artificial lens can shift out of place, especially in eyes with weak support structures

  • May cause double vision or severe blur

  • Solution: Surgical repositioning or replacement of the lens

8. Dry Eye or Surface Irritation

  • Can be worsened after surgery, especially in older patients or those with preexisting dry eye

  • Solution: Lubricating drops, omega-3s, or regenerative therapies

9. Ptosis (Drooping Eyelid)

  • Can occur after surgery due to instrument pressure on the eyelid

  • Usually resolves on its own

  • Solution: If persistent, minor surgical correction is available

10. Posterior Capsule Tear

  • The capsule behind the lens can tear during surgery, especially in complex cases.

  • This may increase the risk of lens dislocation, retinal detachment, or delayed inflammation.

  • Solution: Careful surgical management and sometimes a different lens implant technique.

11. Glaucoma Flare or Progression

  • Patients with preexisting glaucoma may see worsening after surgery.

  • Solution: IOP management, medication adjustments, and follow-up.

12. Iris Prolapse

  • Part of the iris can slip out of the surgical wound, usually due to wound instability.

  • Solution: Surgical repositioning and secure wound closure.

13. TASS (Toxic Anterior Segment Syndrome)

  • A sterile inflammatory reaction caused by contaminated surgical tools or solutions.

  • Rapid onset of pain, redness, and cloudy cornea.

  • Urgency: Immediate steroid treatment is essential.

14. Rebound Iritis (Chronic Inflammation)

  • Inflammation can return after tapering off steroid drops too soon.

  • Solution: Restarting anti-inflammatory therapy and slower tapering.

15. Photophobia (Light Sensitivity)

  • Often due to inflammation, dry eye, or lens edge effects.

  • Solution: Anti-inflammatory drops, blue light filters, or sunglasses.

16. Corneal Edema (Swelling)

  • The cornea may swell post-surgery, leading to blurry or hazy vision.

  • Usually temporary but may persist in those with weak corneal endothelial cells.

  • Solution: Hypertonic saline drops, anti-inflammatories, or corneal surgery if severe.

17. Dysphotopsia (Glare, Halos, Shadows)

  • Caused by lens edge reflections or implant position.

  • Positive dysphotopsia = halos or arcs; negative = dark shadows or blind spots.

  • Common in the early healing phase

  • Often improves with time, but can persist in some patients

  • May be more pronounced with multifocal IOLs

  • Solution: Time, managing light exposure, choosing different lens types if needed, lens exchange, or piggyback IOLs in rare cases.

18. Hyphema (Bleeding in the Eye)

  • Blood in the front chamber of the eye, often from iris trauma.

  • Solution: Elevate head, rest, and monitor. Rarely requires surgical drainage.

19. Persistent Eye Pain

  • Ongoing pain may signal dry eye, inflammation, nerve irritation, or more serious issues.

  • Solution: Full evaluation, tear support, or nerve pain treatment.

20. Inflammation (Uveitis)

  • Mild inflammation is expected—but prolonged or severe cases need attention.

  • Solution: Anti-inflammatory drops or oral meds based on severity.


🛡️ What You Can Do to Reduce Risk

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