What are the Disadvantages of Cataract Surgery?

Cataract surgery is a quick and simple surgery with a high success rate. However, the success rate depends mainly on the precautions after cataract surgery for your recovery. 

Cataract surgery removes the clouded natural lens in the eye and replaces it with an artificial one called an intraocular lens (IOL). Nowadays, cataract surgery is done by phacoemulsification, a process where ultrasound waves break up the cataract then those pieces are sucked out by a probe. This procedure helps in faster and more gentle recovery. Nevertheless, there are many disadvantages of cataract surgery. 

What Are The Different Types of Cataract Surgery?

Most modern cataract surgery involves replacing your natural lens with an IOL (intraocular lens). Cataract surgery can be divided into manual and laser-assisted cataract surgery:

• Manual Surgeries:
  • Phacoemulsification- In this, ultrasound energy is used to break the clouded lens into tiny fragments that are later suctioned out through a vacuum.
  • MECCS (Manual extracapsular cataract surgery) – It is a type of eye surgery where the eye’s lens is removed, and the elastic capsule which covers the lens is left partially intact. This allows the implantation of an intraocular lens (IOL)
  • MSICS (Manual small incision cataract surgery)- This type of surgery is performed through incisions as small as 1.8 mm.
  • ICCS (Intracapsular cataract surgery)- This procedure removes the entire clouded lens and its capsule from your eye. The incisions made are larger, around 8 to 9 mm.
• Laser-assisted cataract surgery:
  FLACS (Femtosecond laser-assisted cataract surgery) is a bladeless eye surgery using a computerized laser to remove the clouded lens.

Usually, laser-assisted cataract surgery is a preferred option by surgeons when compared to traditional manual surgery, but not by a large margin.. Laser-assisted surgery is better if the patient has astigmatism (a condition where the front of your eye has an irregular shape causing blurry vision). Statistics have also shown no significant difference in visual outcomes between the two cataract surgery techniques. Laser-assisted surgery is recommended when your doctor wants to make precise incisions to decrease pre-existing astigmatism. 

Disadvantages of Cataract Surgery

Cataract surgery is the removal of the clouded lens and replacing it with a new intraocular lens (IOL). Like any other surgical procedure, cataract surgery has its own set of advantages and disadvantages. Let’s explore the disadvantages associated with different types of cataract surgeries.

• Phacoemulsification cataract surgery
  • This cataract surgery may require changing the lens by repeating the procedure every 15  to 20 years. 
  • There is an increased risk of unpredictable bleeding and infections, leading to an increased risk of complications post-surgery.
  • The procedure involves using expensive devices and instruments, which can increase the cost for the patient. The use of disposable equipment adds to the cost of the surgery.
  • As this procedure requires expertise, training is essential for the surgeon to perform this surgery. Older surgeons do not perform this technique due to a lack of surgical skills and training.
• Microincision Cataract Surgery (MICS)
  • The limitation of this surgical technique is that MICS cannot be performed in all types of cataracts.
  • There is increased risks of complications associated with this technique namely:
    • Retinal detachment
    • Corneal Edema
    • Increased intraocular pressure
    • Infections
  • This is a more expensive procedure than other types of cataract surgeries.
  • This surgery demands the use of premium IOLs and most people cannot afford the premium IOLs. Hence, this surgery loses its charm.
  • Extensive training is required to perform this technique, especially in the use of bimanual irrigation-aspiration handpiece and fluidics-phaco energy combination. Most surgeons are not well equipped to do so.
• Extracapsular cataract extraction (ECCE)
  • One of the most common complications with ECCE after cataract surgery is posterior capsular opacification (PCO).  In this condition, the back of the lens that wasn’t removed during the surgery now supports the new lens becoming cloudy and impairing your vision.This may causes loss of vision years after the cataract surgery
  • Frequent inflammation of the iris is a disadvantage of this cataract removal technique.
• Femtosecond laser-assisted cataract surgery (FLACS)
  • The use of a femtosecond laser will add to the procedure time.
  • There are increased risks and complications associated with this surgery.
  • The main disadvantage of this type of cataract surgery is the surgeon’s skills and capabilities for programming the laser used during the procedure. A well-trained surgeon only will be able to perform this procedure.

General Disadvantages of All Types of Cataract Surgery

Cataract surgery has both advantages and disadvantages. The disadvantage of manual and laser cataract surgery is similar as the two techniques have no major procedure difference.

• Post-surgical complications that occur after all types of cataract surgeries:
  • Infections 
    • This may lead to itching, burning sensation, and redness.
    • There could be mild discharge from the operated eye.
    • This may also lead to the development of high grade fever.
  • Allergic reactions to the anesthetic drop used
    • You may sometimes have allergic reactions to the anesthesia causing
      • Shortness of breath
      • Nausea and vomiting
      • Dizziness
  • Dry eyes 
    • Dryness of the eyes can cause excess itching, burning sensation and redness of the eyes. 
• Occasional unintended side effects:
  • Glaucoma– An eye condition in which there is rise of intra-ocular pressure in the eye that leads to the damage of the optic nerve.
  • Retinal detachment– An emergency condition in which the retina at the back of the eye gets detached from its place, leading to vision loss.
  • Double vision– Medically known as diplopia, is a condition where two images are seen instead of one.
  • Loss of vision– This means the complete absence of vision- blindness
  • Bleeding in the eye– This is usually due to injury during the surgery. Also known as hyphema, bleeding occurs in the eye’s anterior chamber, between the iris and the cornea.
  • Toxic anterior segment syndrome (TASS)– This complication can arise 12 to 48 hours post-surgery due to a non-infectious substance entering the eye during the surgery. This can cause severe inflammation and, if not treated, may lead to vision loss. 
  • Iris prolapse– During surgery, the iris can come out of the incision  (prolapse), leading to its damage. This is an emergency and must be treated immediately.
• Cost of Cataract Surgery
  • Laser-assisted cataract surgery is comparatively more costly than manual surgery owing to the advanced laser technology and state-of-the-art equipment.

Takeaway

The rewards of cataract surgery are higher than the risks associated with it. Avoiding the slightest chance of a problem by carefully selecting a best cataract surgeon in bangalore , following post-op instructions, and reporting any symptoms of a potential complication can help you get the best possible outcome.

Consult Medfin doctors to curate the best way to cure your complications after cataract surgery. Trust our experts to find the methods that best suit you at Medfin.