Is it possible for vision to deteriorate after cataract surgery?

Question

Dr David Chan · Accepted Answer

First of all, you need to imagine our eyes working like a camera, all parts of the camera from the external aperture and shutter to the internal lenses and film have to all be well-functioned to give you a clear image. It is akin to our eyes from the cornea all the way to the lens and ultimately the retina. Every structure in the eye has to be in a healthy state to give you good vision, regardless of whether you have cataract surgery or not. In short, the answer would be a yes to your question. Deterioration in vision is multifactorial which could be due to other underlying eye issues like age-related macular degeneration, glaucoma, diabetic retinopathy, retinal detachment, and the list is non-exhaustive as the eye is a complex organ.

It is therefore important to seek consultation from an eye specialist to find out the cause of vision deterioration. If we are to view this question microscopically for possible causes of declining vision arising from cataract surgery alone, it could include post-op complications like swelling, inflammation, and infection; though the likelihood is low for cataract surgery. In such cases, close monitoring is required and treatment will vary based on severity. Another possibility is posterior capsule opacification in which the capsule that holds the artificial lens implant becomes cloudy due to cells growth. As such, the patient may benefit from a relatively simple procedure called laser capsulotomy to create an opening in the opaque capsule that allows light to enter the eye and restore vision.

Dr E-Shawn Goh · Answer

Absolutely. This used to be most common previously due to a condition called posterior capsular opacity. This is a condition where even the tiniest residual lens epithelial cells left remaining in the lens capsular bag would migrate before the acrylic intraocular lens, and continue to reproduce. This would result in a minor retro-lenticular opacity that would cause blurring of images (almost akin to a "second cataract"). Thankfully this condition is much less common than it used to be (likely due to a combination of modern cataract surgery techniques, and modern square-edged intraocular lens designs). The treatment for this condition is a very short, and painless laser procedure that creates an opening in the posterior surface of the lens bag. This clears the visual axis of the cellular opacity, and restores clear vision to the post-cataract patient again. You should consult your attending Ophthalmologist for specific details pertaining to your individual conditions. Best of luck!

Dr Yong Ming Por · Answer

Vision can deteriorate for any number of reasons, with or without a history of prior cataract surgery. For example, somebody who previously had cataract surgery could still develop things like corneal swelling, glaucoma, or macular degeneration, or retina detachment, etc...the list of conditions that affect vision is very long.

But if we confine ourselves to causes that are related to the original cataract surgery, the most common cause of blurriness in an eye after cataract surgery is probably what is called 'posterior capsule opacification'. This happens when a layer of cells grows behind the lens implant and blocks or scatters light, thereby causing visual blurring.

If this is the problem, treatment is a simple laser capsulotomy procedure.

As such, do consult with your eye doctor if your vision has deteriorated after cataract surgery.