Answers by Dr. Mitchell Gossman, an ophthalmologist at Eye Associates of Central Minnesota, located in St. Cloud
Why might vision be blurry after successful cataract surgery?
Cataract surgery involves removing the cloudy lens that’s causing blurry vision or other symptoms, and replacing it with a clear artificial lens.
Don’t let this article frighten you about surgery. Complications can happen with any medical procedure, and we tell you about these possibilities so you can decide if the risk is worth the benefit of having surgery.
In the medical field, surgeons cannot detail every possible complication that can happen with a procedure, including cataract surgery. Books have been written describing possible complications that can happen, but so many are so rare it’s impossible to delineate all of them. However, we do mention the ones that are more common, and those that can be devastating.
Some of the more common complications are:
• Persistent swelling of the cornea
• Swelling of the retina
• Retinal detachment which when detected early can be treated
• Fragments of the cataract remaining in the eye that need to be removed later
Some rare complications that can result in blindness are:
• Infection
• Bleeding
• Optic nerve damage
• Retinal detachment in severe cases
Statistics depend on the study you read, but the risk of salvageable complications is about 1 percent and the risk of a blinding complication is about 1 in 10,000 to 20,000. To compare with a more familiar surgery, the risk of death with gallbladder surgery is about 1 in 300.
Most causes of blurry vision after surgery are not complications at all.
• There may be fluctuations in the glasses prescription after surgery. This is an easy fix. We would all like to have perfect vision without glasses after surgery, but there is no guarantee of this right after surgery or over the years.
• It’s common to develop a clouding of a membrane that sits behind the lens and supports it. It’s initially transparent after surgery, but becomes cloudier with time in about 30 percent of patients, and this is easily remedied painlessly in the office with a laser, and it almost never returns.
• Sometimes the cornea is cloudy after surgery, especially with more severe cataracts or with some cornea diseases. In time, this resolves in the vast majority of cases, so patience is advised.
• Often there are other eye conditions other than cataract, such as macular degeneration or glaucoma. These are discussed prior to surgery, cautioning the patient to not expect perfect vision.
Some causes of blurry vision are due to unforeseeable circumstances. It’s possible that the cataract was so cloudy that it was not possible to see to the back of the eye to identify other eye conditions. These may be discovered on the exam after cataract surgery, and need to be treated of possible. A cataract dense enough to block the view of the back of the eye is also beneficial since it permits proper examination and treatment of an underlying problem.
It’s also possible that there’s a visually significant problem that’s not visible on examination since it’s affecting the visual system behind the eye and in the brain. Having cataract surgery where the vision is blurrier than can be explained on the eye exam is cause to investigate further.
Only you can decide if cataract surgery is right for you, and ophthalmologists would be remiss if we didn’t explain the possibility of there being problems afterward.
Find out more
Dr. Mitchell Gossman is a comprehensive ophthalmologist, along with Dr. Melanie Thares, an optometrist, at Eye Associates of Central Minnesota. The office is located at 628 Roosevelt Road, Suite 101, in St. Cloud. To make an appointment or to learn more, call 320-774-3789 or email info@eaofcm.com.
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