The safety and potential risks of cataract surgery
Jane: That sounds super. Thank you. And cataract surgery sounds very straightforward, but you can never call an operation straightforward, particularly an ocular one.
Jaheed Khan: No
Jane: There must be some potential risks, however, small they are.
Jaheed Khan: You are right Jane. Unfortunately, there is no operation that is a 100% safe because that is just life, but what we do is minimise any risks of cataract surgery.
But it is important to highlight the potential risks, no matter how small and I quote around 4% of patients who have a minor complication. Now that means that it may not have gone as routinely as we hoped, but they can be sorted out at a later date, and that may involve more drops, a longer period of recovery or possibly a further surgical procedure to correct the…
Jane: Surgical, laser or either/or?
Jaheed Khan: Surgical, possibly, if we have issues with the lens implant. Laser or treating complications. It is not a complication with the laser treatment; it is more of side effect of the way we do cataract surgery.
Jane: We will come on to that in a minute.
Jaheed Khan: 4% is the quoted national standard for minor complications, but there also are major complications.
Now about one in two and a half thousand people have an infection inside the eye that usually develops on day two or day three after the cataract surgery.
Jane: How would you know?
Jaheed Khan: A patient in that scenario will likely suffer from severe pain and redness and blurriness. Now, I always tell my patients that after cataract surgery each day should get better, but if it gets worse and becomes more and more painful they should phone me and should get checked for infection
Jane: Redness, pain or blurriness are the red flag symptoms?
Jaheed Khan: Absolutely. And I am more than happy to see people early and make sure. If we get an infection inside the eye, that can become quite a big problem if left untreated.
If we can treat that infection early, i.e. on the day when we notice it, we can reverse the infection, and the long-term outcome of the vision tends to be good. If you leave it a week or so sometimes the inflammation has taken hold of the eye, and the vision can be quite blurred afterwards, so recognising the signs early, making sure that we treat early is the key to treating that complication.
There is another complication which is even rarer, but it is worth mentioning that about 1 in 10,000 people may have a severe bleed within their retina at the time of surgery. Thankfully it is very rare, and we tend to reduce the risk of that by measuring people’s blood pressure before the operation. We know that if the blood pressure is very high at the time of the operation, the chance of having a bleed like this is much higher. It is still quite rare, and that can lead to the problems long term with the vision, but those two complications as I say we will reduce the risk of with preventative measures.
The minor complications result in good vision eventually, but I think the take-home message is that 96% of people who have cataract surgery have excellent results and it is probably one of the most successful surgical procedures we do in the world, so it is quite reassuring to know that.
Jane: That’s impressive. It is also reassuring to know that you as a professional can deal with most of the complications as well.
Jaheed Khan: Yes. Early recognition and prompt treatment is the key.