How safe is a cataract surgery, and what are the main risks of going for cataract removal in Singapore?Eye Health Cataracts
My grandmother is worried about her cataract operation, and going blind in particular. What are the main risks of cataract surgery, in the short and long run, so that our family can better advise her?
Cataract surgery in Singapore is a very safe procedure, with more than 99% success rate. Having said that, any kind of surgery carries some risk even if very low. The risk of blindness is quoted at 0.0001% (approximately 1 in 10,000).
The main complications that may arise during cataract surgery are:
- Infection – First of all, this complication is very rare (1 in 1000). Even with the best precautions including copious antibiotic coverage before, during and after surgery, there is still a small risk of eye infection. The infection could come about from unclean surroundings, microbial contamination or a lowered immune system. Your eye doctor will be able to advise you on how to boost your eye health and general well-being after surgery.
- Bleeding – Again, this complication is very rare. During any surgery there is always a risk of excessive bleeding in or at the back of the eye. This occurs especially in those who have uncontrolled high blood pressure or are on pre-existing blood thinning medication. It is important to inform your doctor about the medicines you are taking so that they can be stopped prior.
- Posterior Capsular Rupture – This describes a tear or break in the bag which holds the lens during the cataract removal. Without getting too technical, this complication makes the whole surgical procedure longer, surgery cost higher and visual recovery slower. Depending on the severity of the tear, some surgeons will be able to manage independently during surgery, while other surgeons may need to call in a retinal specialist for their expertise in this area. Although this complication occurs rather uncommonly, it is ideal to have a surgeon who is competent enough to handle it if and when it occurs.
- Retinal tears or detachment – Due to turbulence created within the eyeball during surgery, rarely a retina tear or detachment can occur. If detected early, it can be fixed by a retinal specialist without any permanent damage to the vision. It is important to have an eye doctor who pays attention to your retina during cataract surgery as well.
- Injury to the surrounding tissue such as the eyelid, cornea and iris can occur during cataract surgery. This is uncommon especially in the hands of a skillful surgeon.
- Anaesthetic Risk – There is always a small risk of any kind of anaesthesia to your brain, heart and lungs. It is important to have the surgery done with the support of a good anaesthetist who will be there to take care of your brain, heart and lungs while your eye surgeon is operating on your eyes.
During the recovery period, it is usual for the eye to experience inflammation which may result in transient eye redness, eye swelling, changes in eye pressure or transient retinal swelling. These temporary effects can be treated easily with eyedrops or medication if detected early by your surgeon. Hence, it is important to continue regular follow-up checks after surgery.
In the long run, it is usual for the intraocular lens to accumulate tissue cells or opacification with time (1 to 5 years later). This is can managed with a simple office laser procedure which ‘polishes’ the lens to its original clear condition again.
Dr Claudine Pang
MBBS, MRCSEd, FRCSEd, FAMS (Ophth)
The answer to whether one can go blind from cataract surgery in a word is yes. However, the likelihood of losing sight is very low. Cataract surgery is the most commonly performed elective surgery with success rates in excess of 95%. Serious complications include infections with rates as low as 0.01%.
Once done successfully, patients have their vision restored and their cataract problem permanently sorted. Occasionally, a layer of cells may grow on the back surface of the lens implant months or years after the surgery. This can affect the vision, giving the patient an impression that the cataract has returned when in reality it has not. This condition, known as posterior capsular opacification, can be easily solved with a 2-minute laser treatment.
Dr David Chan
MBChB, MMed, FAMS, MRCS, FRCS
290 Orchard Road
#07-09 Singapore 238859
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