Specialties: Uveitis, Ultrasound Cataract Surgery, Femtosecond Laser-Assisted Cataract Surgery, Retinal Diseases and Surgery, Macular Diseases and Surgery, General Ophthalmology, Children's Vision Care, Glaucoma

Cataract surgery is now one of the safest and most mature ophthalmic procedures, with an overall success rate exceeding 98% and substantial postoperative visual improvement for most patients. Like all medical interventions, however, a very small chance of complications remains.

[Surgical Risks]

1. Intra-operative risks

• Capsular rupture?(? 0.5 – 2 %): The delicate lens capsule may tear during cataract removal, affecting placement of the intra-ocular lens (IOL).
• Iris injury?(< 0.5 %): Manipulation may stretch or damage the iris, causing temporary light sensitivity or pupil distortion.
• Corneal endothelial damage: Mild transient edema is common; persistent edema is rare (< 1 %) and correlates with longer surgery or higher ultrasound energy.
• Hemorrhage: Minor hyphema occurs in ? 0.1 – 0.3 % and usually resolves spontaneously. Severe bleeding (e.g., choroidal hemorrhage) is extremely rare (< 0.01 %).
• Difficult IOL implantation?(? 0.5 %): Small pupils or zonular weakness may require alternative fixation methods.

2. Post-operative risks

• Endophthalmitis?(? 0.01 – 0.05 %): The gravest but very rare infection; prompt treatment is vision-saving.
• Ocular hypertension or hypotony?(? 1 – 3 %): Usually transient and medication-responsive.
• Posterior capsule opacification (“secondary cataract”)?(? 10 – 30 %): The most common late complication; easily treated with outpatient laser.
• Retinal detachment?(? 0.1 – 0.5 %): Higher risk in high myopia; flashes or floaters require urgent review.
• IOL decentration or dislocation?(? 0.1 – 0.7 %): Surgical revision if vision is affected.
• Corneal edema: Mild swelling is common; persistent severe edema is uncommon (< 1 %) and may necessitate corneal grafting.

[Prevention]

1. Pre-operative preparation

• Comprehensive ocular assessment
• Optimize systemic conditions?(e.g., blood glucose, blood pressure, cardiovascular status).
• Full disclosure of medications and history?(anticoagulants, antiplatelets, prior surgeries, bleeding tendencies) for peri-operative adjustment.

2. Intra-operative safety measures

• Experienced surgeon and team?significantly reduce complications such as posterior capsular rupture or vitreous loss.
• Advanced technology?(femtosecond-laser–assisted cataract surgery, Zepto-guided capsulotomy, capsular tension rings) enhances precision and stability.
• Strict asepsis?(thorough operating-room sterilization and intra-operative antibiotics) minimizes infection risk.

3. Post-operative care

• Regular use of prescribed drops?(antibiotic and anti-inflammatory).
• Avoid eye-rubbing or unclean hands?to prevent infection.
• Limit strenuous activity and heavy lifting?to avert wound dehiscence, IOL shift, or pressure spikes.
• Scheduled follow-ups?for timely detection of changes.
• Vigilance for warning signs?(sudden vision decrease, severe pain, redness, new floaters) — seek immediate care if present.

[Management of Complications]

Why Choose Far Eastern Memorial Hospital Ophthalmology?

Selecting the Far Eastern Memorial Hospital eye team ensures thorough pre-operative evaluation, cutting-edge equipment and techniques, and rigorously controlled sterile conditions, all of which markedly reduce surgical risk and boost success rates. With comprehensive treatment facilities, the department can provide prompt, tailored solutions for any unexpected issue, safeguarding your visual health.

[References]

1. Lundstrom M, et al. Risk factors for posterior capsule rupture in cataract surgery: a study based on 55,567 cataract procedures from the Swedish National Cataract Register. Ophthalmology. 2009;116(3):482-487.
2. Royal College of Ophthalmologists. Cataract Surgery Guidelines 2023.
3. Olson RJ, et al. Cataract surgery and intraocular lens implantation: current practice patterns. Curr Opin Ophthalmol. 2020;31(1):43-50.
4. Vasavada AR, et al. Managing the small pupil in cataract surgery. Curr Opin Ophthalmol. 2016;27(1):46-54.
5. West ES, et al. Risk of endophthalmitis after cataract surgery in the United States Medicare population. Ophthalmology. 2005;112(9):1388-1394.
6. Aslam TM, et al. Posterior capsule opacification. Br J Ophthalmol. 2004;88(10):1420-1426.
7. Erie JC, et al. Risk of retinal detachment after cataract extraction, 1980-2004: a population-based study. Ophthalmology. 2006;113(11):2026-2032.