Possible complications after cataract surgery

The article was professionally consulted with Specialist Doctor I Nguyen Thi Bich Nhi - Ophthalmologist - General Surgery Department - Vinmec Nha Trang International General Hospital.

The development of modern medicine and methods has made cataract surgery much simpler. However, complications after cataract surgery may still appear, of which the most important factor is neglect in care and protection of the eye after surgery.

Cataract is a common eye disease common in the elderly, in some localities, also known as dry cataract, cataract but actually is a cloudy phenomenon in the eye lens, causing many disorders. sight. The most common cause of the disease is the aging process of the eyes. The lens is a structural element in the eye that functions as a lens to help focus light on the retina. The retina is the layer that senses light and sends visual signals to our brain. The lens is composed mainly of water and proteins, and these proteins are ordered to allow light to pass through and focus on the retina. In normal eyes, light passes through the lens and focuses on the retina, so the lens of those people will be transparent to create a clear image. In people with cataracts, the proteins of the lens gather in clusters, scattering the light that passes through, creating opaque areas in the lens that block light from reaching the retina and reduce vision. . In the early stages, people may have no symptoms because only a small part of the lens is cloudy. However, gradually the cataract becomes more and more cloudy and the patient's vision becomes more blurred because of the reduced light reaching the retina. In the early stages, patients can use assistive glasses in combination with good light sources to reduce visual disturbances caused by cataracts. But after a while, gradually more and more cataracts become cloudy and the patient's vision becomes more blurred because of reduced light reaching the retina. At this time, the patient needs medical intervention such as surgery to improve his vision. Some people think that cataracts are common in both eyes, but studies have shown that the disease does not spread from one eye to the other.
Scientists are still doing more research on cataracts to find out the specific cause and offer preventive measures, but the cause of the cataract is still unknown. Scientists think that the predisposing factors to cataract can be smoking, diabetes or living environment
Most common symptoms:
Blurred vision Feeling of glare when looking at light : The headlights are too bright at night, dazzling when looking at lights or strong sunlight, or seeing halos around lights. Color seems lighter. Night vision is worse. Look at a formation of two or more shapes. The glasses you are wearing change frequently. These symptoms can also be signs of many other eye diseases, but when a patient has these symptoms, they should go to an eye doctor for examination and advice, giving timely solutions to the patient. .
Types of cataracts include:
Cataracts due to aging: Most cataracts are caused by old age. Congenital cataract Secondary cataract: Develops in people with certain medical conditions, for example diabetes. Cataracts can be caused by prolonged use of steroid medications. Traumatic cataract When the patient feels some signs of eye disease in general and cataract in particular, it is necessary to have a comprehensive eye exam to clearly determine the situation of the disease, including the following: the following steps:
Measure vision using the vision table. Eye exam with dilated pupils: Using eye drops to dilate the pupils allows the doctor to examine the lens and retina closely and check for other eye diseases. Measurement of eye pressure: Routine measurement to check the pressure in the eye, if the eye pressure is increased it can be a sign of glaucoma (glaucoma). Do some other tests if needed to look at the structure and possible disease of the eye

For patients with early cataracts, they can use glasses, use magnifying glasses or have good light when working. However, when these measures do not work, only surgery is the most effective treatment. Surgery removes the cloudy lens from the eye and places a lens to replace the lens. This surgery is indicated when the cataract causes vision loss that interferes with daily activities, such as being unable to see clearly while driving, reading, or watching TV. If a person has cataracts in both eyes, the doctor will not operate on both eyes at the same time, but each eye will be operated at two different times because the disease does not spread to the other eye. If the eyes are affected a lot, the surgery can be done 2 to 4 weeks apart. In some cases, it is possible to remove a lens without causing vision loss, but it interferes with the examination and treatment of other eye conditions, such as age-related macular degeneration or diabetic retinopathy.
Currently, cataract surgery is one of the most popular surgeries in Ophthalmology. It is also one of the safest surgeries and gives very good results. With advanced techniques and modern equipment and a team of qualified medical staff, the surgery usually has a very high success rate.
Doctors often use two ways of obtaining vitreous. Your doctor will explain in detail how the two surgeries are different and help them decide which is best:
vitreous emulsification or phaco : This method makes a small incision in one side of the cup. desert. Then insert a small device into the eye. This device emits ultrasound waves that soften the lens and break it into small pieces that can be sucked out. Currently most vitreous surgery is done by phaco method, also known as small incision surgery. Extracapsular lens removal method: A longer incision is made on one side of the cornea and the hard nucleus is removed. Then suck up the leftovers. After the vitreous is removed, the doctor will place an intraocular lens in the place of the replaced lens. The intraocular lens is a transparent artificial lens that will become part of the patient's eye for life but does not need to be cared for. The patient's vision will improve well with the intraocular lens because light passes through it to the retina. But the patient also does not feel or see this new lens.
In some cases, it is not possible to place intraocular lenses because of other eye diseases or complications during surgery. In these cases, the doctor will recommend other methods such as wearing contact lenses or wearing glasses after surgery. However, the condition of the eye will not improve as clearly as for the eye that is operated on.
Types of intraocular lenses, also known as artificial lenses, have many types such as:
Monofocal IOLs (helps eyes see clearly a certain distance) Multifocal IOLs (helps eyes see the whole distance clearly) distal and near distance) Toric intraocular lens (helps correct astigmatism of the patient's eye). Doctors will depend on the patient's eye condition, occupation, and financial ability to advise on the appropriate placement of intraocular lenses to help restore the patient's vision in the best way.
For patients, before surgery need to do some test indicators. These tests include measuring the curvature of the cornea, size and shape of the eyeball to select the right type of intraocular lens, and blood tests. Therefore, patients need to fast for breakfast to ensure accurate readings. In addition, the patient needs an internal examination to ensure that the patient's condition allows surgery. The surgery usually lasts no more than 30 minutes and is virtually painless. Most patients receive local anesthetic drops or numbing injections, so the child's eyes are numbed to numb the pain. As a result, the patient remains awake throughout the procedure. After surgery, the patient is bandaged and rested. Doctors will conduct an examination and monitor for complications after surgery. Most patients can go home the same day, but cannot drive by themselves and need the help of relatives to ensure traffic safety.
Although cataract surgery is a simple surgery, there are still cases where cataract complications appear during surgery such as:
Can't completely remove cataract Posterior capsule and may be associated with cataract surgery. Part of the lens drops into the vitreous cavity IOL deviation Bleeding in the eye Damage to other parts of the eye, especially the cornea. Common complications after cataract surgery include:
Posterior capsule : is one of the most common complications after cataract surgery. Inflammation: In the early days or for up to a week after surgery. Retinal detachment: The layer of retina at the back of the eye can be detached after cataract surgery. People with severe myopia have a higher risk of retinal detachment. Glaucoma: This condition occurs because the pressure in the eye is abnormally high. The pressure from glaucoma puts pressure on the retina and optic nerve in the eye. If not treated in time, this disorder can lead to damage to the optic nerve, affecting vision or completely blind. Infection: A serious complication after cataract surgery, occurring with a very low probability, about 0.2%. Bleeding: May occur inside the eye. Although these complications have a lower rate than posterior capsular opacities, if unfortunately encountered, the patient's vision will deteriorate rapidly, even leading to blindness if not corrected in time.
There are many factors that increase the risk of complications after cataract surgery in which the following patients have a higher risk of complications than others, need to think carefully before making a decision to have cataract surgery vitreous:
People with other eye diseases: uveitis, old trauma, glaucoma, severe myopia... People with diabetes People using anticoagulants: Need to stop taking 3-5 days before surgery.

After surgery, patients often feel itching and mild tingling for a short time. Some conditions such as watery eyes, eyes that feel bright and painful, may also occur. If eye discomfort, pain reliever can be applied every 4-6 hours and after 1-2 days the eye pain will be gone. In most cases, the eye heals in about 6 weeks.
Patients should follow up with the doctor's schedule to evaluate the eye condition. In the first days after surgery, patients use eye drops or oral medications to heal their eyes and stabilize their intraocular pressure. Patients should ask their doctor about how to use the medication, when to take it, and what possible side effects to use it properly. Patients also need to wear eye protection to avoid rubbing or pressing on their eyes or external factors such as dust, toxic fumes, etc. Patients should also not bend over or carry heavy objects because this will increase the risk of injury. intraocular pressure.
The patient can quickly return to normal activities, but at first, the eyes may still be blurry. It takes time for the eye to adjust to the other eye, especially if that eye also has a cataract. If an intraocular lens is inserted, the color may appear bright or bluish. When there is a lot of sunlight, you may also feel things a little red for a few hours. Patients should not be too worried, if this phenomenon is seen, it means that the intraocular lens is transparent. These sensations should go away after a few months, but once the eye has healed, it's still a good idea to wear glasses for a while.
Some notes after surgery and eye recovery include:
Do not do heavy work, exert yourself in the first 2 weeks. Do not get water in your eyes for the first 2 weeks. You are not allowed to drive on your own for the first day after surgery. Do not bend over, avoid coughing, strong sneezing in the first day. Do not rub your eyes. Wear glasses to avoid dust. Maintain light activities: Walk, watch TV, read books.... Use prescription drugs, follow-up doctor's appointment. If the patient feels pain and blurred, they need to be re-examined immediately. When cleaning and protecting eyes, it is important to note:
After surgery, the patient will be given a prescription by the doctor and used eye drops. Patients need to use eye drops including antibiotics and artificial tears as directed by the medical staff, use a clean soft cloth and paper to blot around the eyes, avoiding the back of the eye causing infection. Protective glasses need to be worn all day and even when sleeping to avoid accidentally rubbing your eyes Always wash your hands before instilling or touching your eyes Never rub your hands over your eyes, blink vigorously, avoid strong pressure causing injury eyes Do not let soap and water get into eyes, stay away from polluted environment for 1 month Should limit watching TV and technological devices Do not go swimming, bathing, bowing a lot, do not do heavy work and avoid be active for 3 months after surgery Periodic eye exams as directed by the doctor Patients should re-examine according to the doctor's follow-up examination to check the recovery status or come by themselves if experiencing the following complications :
Red, bulging, watery eyes. A sharp or severe pain in the eye. Blurred vision or sudden loss of vision. Headache but without nausea or vomiting. Suddenly seeing black, speckled or floating spots floating in front of your eyes. Patients also need to supplement their daily nutrition as follows: Need to add vitamin C, copper, manganese, zinc, eat foods rich in antioxidants, help good liver function to prevent diseases such as lentils, onions. , garlic, vegetables, cabbage, bean sprouts, fresh beans and seeds...
In addition, the doctor may prescribe the patient some of the following drugs to prevent inflammation and infection from occurring after cataract surgery. vitreous:
Drops: Antibiotics, steroid anti-inflammatory drugs Oral: Antibiotics, anti-inflammatory, pain relievers. Thus, cataract is not a dangerous disease. The disease is common in the elderly due to the aging process. The best way to improve the condition is to perform surgery. After surgery, patients need to follow the doctor's advice and take care at home as indicated to avoid complications after surgery.

To examine and treat eye diseases, you can go to the Eye specialist - Vinmec International General Hospital. The department has a comprehensive vision and eye health care function for children, adults and the elderly including refractive error testing, general examination, diagnostic ultrasound, laser treatment and surgery. In addition, ophthalmology also has the task of coordinating with other clinical departments in the treatment of pathological complications and eye injuries caused by accidents.
Why should you choose to examine and treat eye diseases at Vinmec International General Hospital?
Simple and quick procedure. Enthusiastic advice and support, reasonable and convenient examination process. Comprehensive facilities, including a system of clinics and consultations, blood collection room, dining room, waiting area for customers... The medical staff has high professional qualifications, style. Professional, caring way of working.