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Cataract Surgery Risks: An Informed Patient’s Guide

cataract surgery risks

Cataract surgery is one of the most commonly performed surgical procedures worldwide. It involves the removal of the cloudy lens (the cataract) from the eye and the insertion of an artificial lens. While it’s generally considered safe, as with any surgical procedure, there are potential cataract surgery risks involved. Understanding the possible cataract surgery risks can help you make an informed decision about your health.

Since, serious complications are very rare, we will first cover what are common and temporary symptoms you might experience during or after cataract surgery.

And if you haven’t already done so, check out our complete guide on cataract surgery.

Normal Side Effects/Symptoms of Cataract Surgery

After cataract surgery, it’s normal to experience some temporary side effects as your eye heals. These may include:

  • Mild discomfort, scratchiness, or itching in the eye
  • Blurry vision as your eye adjusts to the new lens
  • Light sensitivity
  • Red or bloodshot eyes
  • Dizziness or nausea from the anesthesia
  • Halos and star bursts around lights

These side effects are usually temporary and should improve within a few days. Your doctor will provide you with specific instructions on how to manage these symptoms and when to seek medical attention.

Uncommon Side Effects/Symptoms That Cause Concern

While most people recover from cataract surgery without any significant issues, there are some less common side effects that may cause concern. These include:

  • Persistent pain in the eye
  • Significant vision loss
  • Flashing lights, floaters, or a curtain-like shadow in your field of vision
  • Persistent nausea, excessive coughing
  • Persistent light sensitivity
  • Persistent redness in the eye
eye redness after cataract surgery

Several of these symptoms are ok to have for one or two days after surgery. Persistence, especially continuing on into the third day is not normal.

If you experience any of these symptoms, it’s important to contact your doctor right away.

Cataract Surgery Success Rate

According to a survey conducted in 2021, cataract extraction is the most prevalent surgical procedure of all medical specialties, with an estimated 3.7 million cases per year in the USA alone.

In 2015, 3 million Americans underwent cataract surgery, according to the American Society of Cataract and Refractive Surgery (ASCRS).

With newer and well-developed techniques, cataract surgery is one of the most successful clinical managements in medicine.

The success rate of cataract surgery is high, with 99.5% of patients having no serious cataract surgery complications.

However, complications can occur during any surgical procedure, and cataract surgery is no exception.

The most common intraoperative complication is posterior capsule rupture, which occurs in 1.95% of cases.

Most Common Cataract Surgery Complication

Posterior Capsular Opacification (PCO), also known as secondary cataract or after-cataract, is the most common complication of cataract surgery. It occurs when a cloudy layer of scar tissue forms on the back (posterior) of the capsule that holds your new artificial lens. This can cause your vision to become blurry, much like it was before your cataract surgery.

PCO can develop months or years after cataract surgery. The symptoms of PCO are very similar to the symptoms of a cataract. They include:

  • Blurred, hazy, or cloudy vision
  • Difficulty seeing or driving at night
  • Sensitivity to bright lights and glare
  • Sudden nearsightedness (myopia)
  • Visual disturbances with bright lights at night, such as halos or starbursts

The treatment for PCO is a simple, painless procedure called YAG laser capsulotomy. During this procedure, a laser is used to create a small hole in the cloudy capsule behind the artificial lens. This allows light to pass through to the retina at the back of the eye, restoring clear vision. The procedure is performed in the doctor’s office and takes just a few minutes. Most people notice an immediate improvement in their vision after the procedure.

Posterior Capsule Rupture

Posterior capsular rupture is on the list of possible cataract surgery complications that eye surgeons want to avoid.

The ‘capsule’ in this case refers to a thin, clear membrane that encloses the eye’s natural lens. When a cataract forms, it’s within this capsule. During cataract surgery, the front part of the capsule is opened so that the cloudy lens can be removed and replaced with an artificial lens implant. The back part of the capsule, known as the ‘posterior capsule’, is usually left intact to serve as a kind of pocket or holder for the new lens.

However, in some cases, the posterior capsule can tear or rupture during the surgery. This is known as a posterior capsular rupture.

If a posterior capsular rupture occurs, it can make the surgery more complex. The surgeon might need to make adjustments to the procedure, such as using different techniques or instruments to safely remove the cataract and implant the new lens. In some cases, a different type of lens might need to be used, or the lens might need to be placed in a different location within the eye.

In terms of the outcome after surgery, a rupture can increase the risk of certain complications, such as retinal detachment or swelling in the central area of the retina (macular edema). It might also mean that your vision takes longer to recover after the surgery.

However, it’s important to note that even if a rupture occurs, most people still experience a significant improvement in their vision after cataract surgery. Your eye surgeon will take steps to manage the situation and minimize any potential impact on your vision.

Serious Complications of Cataract Surgery

Serious complications from cataract surgery are even more rare, but they can occur. These may include:

  • Endophthalmitis, a serious eye infection (<0.25%)
  • Torn or Detached Retina, where the retina at the back of the eye pulls away from its normal position (<0.5%)
  • Suprachoroidal hemorrhage, a severe bleeding inside the eye (<0.1%)
  • Permanent corneal edema, where the cornea becomes cloudy and does not improve on its own
  • Intraocular lens dislocation

These complications can lead to significant vision loss if not treated promptly. If you notice a sudden decrease in your vision, intense eye pain, or other severe symptoms, seek immediate medical attention.

Fortunately, advances in surgical techniques and patient care have led to a decrease in complication rates over time.

Factors Influencing Cataract Surgery Risks

The risk of complications from cataract surgery can be influenced by several factors:

  • Patient’s Overall Health: Patients with other health conditions, such as diabetes or high blood pressure, may have a higher risk of complications.
  • Age: Older patients may have a higher risk of complications due to age-related changes in the eye.
  • Type of Cataract: Certain types of cataracts may be more difficult to remove and may increase the risk of complications.
  • Surgical Procedure Used: The risk of complications can also depend on the specific surgical techniques and technologies used.
  • History of Trauma: Any trauma to the head or eye can lead to weakness in the support structure holding the natural lens.
  • Genetic Eye Conditions: Some pre-existing eye conditions can lead to increase chance of posterior capsular rupture or corneal edema with cataract surgery.
  • Medications: Some medications like Flomax, can cause a condition called floppy-iris syndrome and lead to more complex surgery.

Minimizing Risks with Cataract Surgery

While there are risks associated with cataract surgery, there are also steps you can take to minimize these risks:

  • Choosing an Experienced Surgeon: An experienced surgeon can help reduce the risk of complications.
  • Proper Pre-Operative Care: Following your doctor’s instructions before surgery can help prepare your eye for the procedure and reduce the risk of complications.
  • Following Post-Operative Instructions: After surgery, it’s important to follow your doctor’s instructions for eye care and medication use to promote healing and prevent infection.


Understanding the risks associated with cataract surgery can help you make an informed decision about your treatment. While complications are rare, being aware of the potential risks and taking steps to minimize them can help ensure the best possible outcome.

Always discuss any concerns or questions you have with your healthcare provider.

FAQs About Cataract Surgery Complications

  • What is the most common complication of cataract surgery?

    The most common complication of cataract surgery is a condition called posterior capsule opacification (PCO), also known as secondary cataract. This occurs when part of the lens capsule, which is left in place to hold the artificial lens, becomes cloudy and impairs vision. This is usually treatable with a simple laser procedure.

  • Is cataract surgery a high-risk surgery?

    Cataract surgery is generally considered a low-risk procedure. Serious complications are rare, and most people can return to their normal activities within a few days of surgery.

  • What are the odds of complications from cataract surgery?

    The odds of severe complications from cataract surgery are low. According to a study of over 220,000 Medicare patients, 99.5% did not experience any severe complications.

  • How long does it take to recover from cataract surgery?

    Most people can return to their normal activities within a few days of cataract surgery. Full recovery, including complete healing of the eye and stabilization of vision, typically takes about a month. However, recovery time can vary depending on individual factors such as your overall health, age, and how well you follow post-operative care instructions.