Cataract Surgery – Risks and Complications 

Cataract surgery is a high cost procedure that can be put off or delayed for months, perhaps years. Having this costly procedure done, will depend on the severity of vision loss that an individual may have. Currently the only effective treatment method for vision loss due to this type of eye disease, is extracapsular surgery.

It is a very common medical procedure that involves removing the eye lens that contain the cataract from the lens capsule. This surgery is also called extracapsular cataract extraction or ECCE for short.

Once the lens are removed, it can - in some cases be replaced with an artificial one called an Intraocular Lens Implant.

There are however, times when this type of artificial implant would not be used. In cases like these, the lens are left out and are substituted with prescription eyeglasses or contact lenses. Extra-capsular cataract surgery can be performed with or without phacoemulsification.

The most commonly used one for cataract treatment is extracapsular surgery with phacoemulsification. The procedure is a special one which involves the removal of the eye lens - through the front portion of the lens capsule.

Extra-capsular surgery without phacoemulsification on the other hand, involves having a small incision made in the cornea where it meets the sclera.

Another tiny incision is then made into the front portion of the lens capsule, where the lens is then removed along with any other remaining material of the lens. At this point, an intraocular lens may be implanted in the lens capsule before the incision is closed up.

There may be times when diabetes individuals and others, may need to have extracapsular cataract surgery performed on both eyes. Just like any type of surgery, complications are involved. But in cases like these, the surgery is done on one eye at a time and it is not until the operated eye has healed and its level of vision determined.

Once this is done, then the operation of the other eye be scheduled. The recovery time is just as important as the surgery itself. Now some diabetics may have both glaucoma and cataracts at the same time. If this is the case, both conditions can be operated on at the same time.

One of the side effects of extracapsular cataract extraction surgery, is that it may cause a reduction in the intraocular pressure in the eye that the cataract was removed from.

Improvement in the vision of the individual may occur during recovery - after surgery depending on which one of these conditions originally caused the vision loss. Extracapsular cataract surgery now-a-days, is carried out using local and/or topical anesthetics.

Conditions That Will Require The Use of General Anesthetics

There are times when doctors may need to use general anesthetics. Conditions that may require the use of general anesthesia are as follows:

  • When diabetic individuals with high anxieties can not be controlled with local or topical anesthesia.
  • When diabetics who are unable to follow instructions during the extracapsular surgery.
  • When diabetics and non-diabetics have allergic reactions to certain local anesthetics.
  • When diabetics or non-diabetics have other medical conditions which may require the use of general anesthesia.

Conditions That May Delay Extracapsular Cataract Surgery

Although extracapsular cataract surgery can be delayed for a while, there are certain conditions which may require diabetics and non-diabetics, to have the procedure done immediately.

These include:

  • When an individual's job or daily way of life, is being seriously affected by the cataract.
  • When the glare in the sunlight or any other form of bright lights becomes a serious problem.
  • When an individual can not pass the required eye exam to get a driver's license.
  • When a diabetes person begin to experience double vision.
  • When there is a significant difference in the vision of both eyes.
  • When a diabetes person have other eye diseases such as diabetes retinopathy, glaucoma, and macular degeneration.

Extracapsular cataract surgery have a success rate of 90 - 95 percent in diabetics as well as non-diabetics that are of an older age. Now if the extracapsular cataract surgery is done without phacoemulsification, recovery of an individual's eye sight occurs much quicker.

On the other hand, if the surgery is performed with phacoemulsification, then recovery will take a little longer.

Possible Complications That Can Occur 

If there are serious risks and complications during surgery, (usually with individuals with other eye diseases other than cataracts), there could be some possible vision loss. These complications may include:

  • Endophthalmitis (the individual getting an infection in their eye).
  • Cystoid Macular Edema (when swelling and fluid in the center of the nerve layer of the eye of the individual is present).
  • Corneal Edema (the clear covering of the eye contains swelling).
  • Hyphema (the presence of bleeding in the front of the individual's eye/s).
  • Ruptured eye (capsule bursting).
  • Loss of the vitreous gel (fluid) in the eye/s.

Possible Complications After Cataract Surgery

There are some possible complications that may occur after a diabetic or non-diabetic have had their extracapsular cataract extraction done. These complications may include the following:

  • Intraocular lens becoming dislocated in the eye.
  • Glare still present after surgery.
  • Posterior Capsular opacification (cloudiness of the lens still present after surgery). If this occurs, after a extracapsular cataract surgery, a treatment involving the use of a laser may be required. This type of procedure is called Vitrectormy.

Who is At Risk For Developing Posterior Capsular Opacification?

Individuals that are at the greatest risk for developing posterior capsular opacification, are infants that requires cataract surgery treatment. Sadly they are almost at 100% for developing it.

There is another form of cataract treatment besides the extracapsular surgery, that is used. This treatment involves the use of an eye drop called Mydriatic Eye drops.

This particular eye drop dilates (enlarging) the pupils of the individual's eyes. This can improve the vision of the person by allowing them to see around the cataract. This type of cataract treatment is rarely prescribed by doctors though. However when it is prescribed, it is only used for a very short time.

Unfortunately diabetics that have certain types of glaucoma, are not given this particular medication. Fortunately for parents, the medication can be used in the cataract treatments of infants and small children under the age of 2.

This could be an alternative to the high cost of having undergo cataract surgery in some cases. In any event, we all need to take better care of our eyes so that we can avoid serious risks and complications that are associate with eye disease that will require extracapsular cataract surgery

Extracapsular cataract surgery is a treatment for vision loss due to cataracts.

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