23.7.2024
Lesezeit:
7 minutes

Prospects of success and risks of cataract surgery

Cataract traction is a routine procedure with very good chances of success, yet there are always risks

Dr. Valéry Vinzent Wittwer

Our liability insurance requires us to inform our patients about ALL possible risks of the procedure, even if they are very unlikely.

In general

Despite all care, vision loss or, under certain circumstances, life-threatening complications may occur, which require further treatment measures/operations. The frequency figures are a general estimate and should help to weigh the risks against each other. They do not meet the definitions of side effects in medication package inserts.

General risks of surgery

During the first few days after surgery, redness, tears, and burning of the eye may occur. Eye drops can alleviate these symptoms.
Bleeding into the eye, songs and eye sockets, injuries, infections, accumulation of pus in the anterior chamber of the eye (hypopyon), non-infectious inflammation of the anterior chamber of the eye (TASS) and side effects of medications may require treatment and/or further surgery and rarely result in progressive vision impairment including loss of vision and eye.

In the first few days after surgery, corneal opacities may occur or inflammatory material may accumulate in front of the pupil. This can be treated with medication. If there is previous damage due to age changes, the cornea may remain cloudy and a corneal transplant will be necessary.

Warstration/curvature cornea may cause distorted vision and require secondary surgery or laser treatments.

Damage to the iris of the rainbow is possible and can cause contortion/rounding of the pupil. This is more common when alpha receptor blockers, such as certain prostate medications, are taken. The iris can rarely bulge and result in increased intraocular pressure. In this case, laser treatment or rainbow skin surgery is necessary.

There may be vitreous suspension or vitreous clouding (“floaters”), which are perceived as “flying mosquites/mouches volantes”.

If the gelatinous mass of the vitreous body penetrates the anterior chamber (vitreous prolapse), it is surgically removed during surgery or in another operation (vitrectomy).

In individual cases, or in particular if a glaucoma (persists) before surgery, intraocular pressure may be increased or particularly low. Medication or further surgery may be necessary here to normalize the pressure.

Despite all care, a lens capsule rupture may occur. In this case, it is necessary to insert a special sulcus lens in front of the lens capsule or a rainbow skin-supported lens during surgery or in another operation. This can result in fluid accumulating in the center of the retina at the point of sharpest vision (macular edema). This slows down the recovery of vision and increases the risk of retinal detachment. Very rarely, lens material can fall into the vitreous cavity and further surgery is necessary.

Complications after surgery

It is relatively common for intact lenses to form a so-called “post-star”, which tarnishes the artificial lens. With laser treatment, this can be treated efficiently within a few minutes.

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If not, there are glare phenomena such as halos around light sources (halo), especially at night. Normally, these are suppressed by the brain in the first few months and no longer interfere afterwards.

Rarely do “lens shivering”, “shadow phenomena” or visual problems occur, which are due, among other things, to slipping of the line. An operative correction can improve this.

Visual problems and glare rarely caused by slipping of the lens, which may require further surgery.

In rare cases, the lens strength is not optimal despite careful lens calculation. This can usually be corrected with appropriate glasses. A lens replacement or the insertion of an additional lens or a corneal laser treatment is rarely necessary.

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If the lens thickness deviates only slightly from the intended goal and could be corrected with glasses, but the patient does not want to wear glasses after the operation, this correction will not be covered by health insurance. There are additional costs for the patient if this has not been discussed beforehand. We offer appropriate self-payment packages that include these fine adjustments.

Very rarely, eye irritation may occur, which requires a second operation with replacement of the artificial lens.

In the rarest cases, the pupil remains permanently wide after surgery (Urrets-Zavalia syndrome).

Please ask questions during the clarification interview if there are any uncertainties that seem important to you.

Chances of success

Cataract surgery is generally a routine procedure and the chances of a clear vision are very high.

The chances of success are limited, in particular for existing retinal diseases, additional green star disease and injuries. In order to assess and, if necessary, clarify this, an extensive preliminary examination is carried out before cataract surgery.

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After implantation of multifocal lenses or through monovision, “limited” freedom from glasses can be achieved. Accordingly, most activities in daily life are then possible without glasses.

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