Post cataract surgery issues

For various reasons, what was once a fantastic visual result shortly after surgery, can seem disappointing later on.

There are some common, easily remediable causes for some of these issues.

Posterior Capsular Opacity

Often referred to as ‘a second cataract’, this is not another cataract developing, but merely some clouding of the capsular bag that occurs, usually several years, but sometimes sooner, after routine cataract surgery. You may experience glare, haloes around lights and the return of blurred vision. The good news is that this easily treated with simple laser (YAG) treatment as an outpatient.

Cystoid Macular Oedema

Occurring in approximately 1-5% of patients after surgery, this often occurs 4 to 6 weeks after surgery and patients can notice mild to significant blurring of central vision, possibly with some distortion.

The condition is diagnosed with an OCT scan of your macula, and it can often respond well to anti-inflammatory drops, or in more persistent cases, a local steroid injection.

Implant lens decentration

Occasionally, the implant lens can shift position within the eye. This is an uncommon complication and when it occurs, this is usually several years after the original surgery. It is caused by laxity of the structures supporting the lens bag. Usually this complication is picked up by your optician, as it can lead to significant changes in your spectacle prescription. You may have been aware of more blurred vision in the affected eye, sometimes fluctuating in clarity.

In some cases the problem is remedied by a simple adjustment of your exisiting lens, but usually, where the movement is significant, surgery is required to refixate, or replace the lens implant. The exact procedure depends on a number of factors, and would be discussed with you by your surgeon.

Retinal Detachment

This is a rare event, that is generally more common as we get older, but is more common after cataract surgery, and can occur years after the original surgery.

Patients sometimes notice an increase in floaters (mobile grey/black spots) in the vision followed by a shadow in the peripheral vision, or even a drop in vision if more advanced.