Eye Surgery Can Blind

There are risks to eye surgery, especially intraocular operations such as cataract removal or vitrectomy.  Cataracts are the most common eye surgery and vitrectomy eye surgery is usually performed by a retina specialist for various problems of the retina and vitreous.  Infection, inside the eye, called endophthalmitis, is uncommon, yet can blind.

There are all sorts of “eye” surgery.  There is cosmetic “eye” surgery to lift the eyelids, there is “eye” muscle surgery to correct strabismus (crooked eyes), laser “eye” surgery to get rid of glasses, etc.  These are all procedures that do not invade the eyeball, and thus, are “extraocular” operations; surgeries that stay outside of the eye.

“Intraocular surgery” is surgery that cuts into the eye.  Cataract surgery, certain glaucoma operations and retina surgery are all invasive and, thus, introduce certain risks not found in other types of “eye” surgery.

Infection is the biggest risk of any intraocular procedure.  As with any surgical procedure, there is a risk of infection.  Intraoculuar infection; however, can be devastating to the vision as it can cause blindness.  Most cases of “endophthalmitis” occur shortly, within days, after intraocular surgery.  The cause is usually due to aggressive bacteria that attack the inside of the eye leading to damage of the retina.

The damaged retina, even after the infection is controlled, does not see.

Endophthalmitis following cataract surgery is estimated to be less than 1/2000.  Endophthalmitis from vitrectomy retina surgery is even less common.  I usually give the estimate of about 1/10,000 or lower.  Certain types of glaucoma surgery carry a life long chance of developing an infection.

Symptoms of endophthalmitis are pain and decreased vision, although with advances in technology, these symptoms are sometimes less apparent.  In general, if there are concerns about pain or decreased vision following eye surgery, make sure your doctor is aware.  The results can be devastating.

Early identification of possible infections is really, really key.  Treatment can range from antibiotic injections, intravenous antibiotics and vitrectomy surgery.

Retinal detachment is the second biggest risk of intraocular surgery.  By operating inside the eye, an inadvertent retinal tear can be made in the retina leading to a retinal detachment.  Retinal detachments usually do not lead to blindness, but they can.  Additional retinal surgery could be necessary to repair the retinal detachment, but some visual loss is possible.  The chance of developing a retinal detachment following intraocular surgery is somewhere from 1-3%.  Again, with advances in technology, I believe this rate has decreased over the past decade.

Other risks of intraocular procedures are relatively minor, but can include bleeding, but most bleeding into the eye is usually self-limited, sounds horrible, but usually does no permanent damage.  Cataract formation can be caused or enhanced by retina or glaucoma surgery.  This is not a true risk, per se, but hastened cataract formation following intraocular surgery is common.  Sometimes the intraocular pressure can be too high or low following surgery.  There are many reasons why either can occur.

What Does This Mean? These are the most common, and feared, complications of intraocular eye surgery.  This is not a complete listing, but certainly items that should be considered when contemplating surgery.

Your eye surgeon should be able to comfortably discuss, with you and your family, the risks and benefits of any surgery offered to you.  If not, move on.

Eye surgery, especially in America, is extremely safe.  Don’t get me wrong, cataract surgery enjoys about a 99% technical success rate, that is, over 99% of the time the cataract is removed and replaced with an implant…as planned!  Retina and glaucoma surgery, too, are both very successful and usually performed with a high rate of technical success.  Technical success is defined as the ability to perform the actual surgical task.

Complications are the risks undertaken with surgery despite technical success, and no surgery, however, is without risk.

Reblog this post [with Zemanta]


Randall V. Wong, M.D.

Ophthalmologist, Retina Specialist
Fairfax, Virginia

Google
***This post is for information purposes only. This posting does not offer legal or medical advice, so nothing in it should be construed as legal or medical advice. The information on this blog/post is only offered for informational purposes. You shouldn’t act or rely on anything in this blog or posting or use it as a substitute for legal/medical advice from a licensed professional. The content of this posting may quickly become outdated, especially due to the nature of the topics covered, which are constantly evolving. The materials and information on this posting/blog are not guaranteed to be correct, complete, or timely. Nothing in this posting/blog and nothing you or I do creates a doctor-patient relationship between you and the blog; between you and me; or between you and Randall Wong, M.D. or RetinaEyeDoctor.com. Even if you try to contact me through the blog or post a comment on the blog you are still not creating a doctor-patient relationship. Although, I am a doctor, I’m not YOUR doctor until and unless there is a written agreement specifically providing for a doctor-patient relationship.***

Comments

  1. teresa weber says:

    Great info! Teri

  2. Thanks for commenting. Too many people think eye surgery is risk free. It is pretty safe, but not guaranteed.

    Randy

  3. Thanks Doc,
    You give us floater sufferers hope, even all the way over here in Australia!

    Regards
    Jake

  4. Dear Jake,

    Thanks for the comment!

    All the best!

    Randy

  5. Dear Dr. Wong

    In regards to cataracts, does the age of patient undergoing FOV have much of a factor as to how soon after you could be expecting cataract formation? I am 23 yrs old, and have got these damned floaters around 4 months ago after a mild concussion. Waiting to see if they will improve on their own befor going under the knife (or vitrector in this case!)
    Kind regards
    Jake

  6. Rocky Saxena says:

    Should i wait another five or seven years to get eye surgery? That way technology will advance and if i become blind from surgery, the doctors will have a better chance in fixing my eye? By the way i’m 19 years old. I wear contacts that i think are -6.5.

  7. Dear Rocky,

    What are you talking about? What kind of eye surgery?

    r

  8. Doc, I have been diagnosed with a vascular neoplasn of the conjunctival OS, the opthalmologist is concerned about malignancy due to the recent onset of vascularization and has scheduled me for surgery. I am truly nervous and want to find out if you think my benefits outway my risks with this type of situation. Scheduled for surgery aug 24th. MD said she has never seen “feeders” like this before.

  9. Good luck next week. I think it is only in your best interest.

    Randy

  10. I appreciate your risk comments. I am a new sjogrens with RA diagnosis and my iop has climbed to 26 in about nine months. Only one md does these trab. And I fear infection from surgery. I trust my long term glaucoma MD but wonder if I should compare outcomes with 2-3 surgeons?

  11. Dear Linda,

    I don’t blame you for being hesitant. If you trust your glaucoma MD, ask him/her for guidance.

    Best of luck.

    Randy

  12. I had a retinal detachment repair in October 2011 which was related to my Retinoschisis. After the gas bubble was absorbed I noticed a significant loss of my temporal vision. There is no infection no discomfort – I know there are risks but what are the chances the sight will come back?

  13. Dear Teri,

    Sounds weird. I’d ask your doc the same question.

    r

  14. Hi,
    my uncle is 75,he has been blind in 1 eye all his life and recieved lazer treatment on his other a few weeks ago which caused the pressure in his eye to raise to 38, after hospital and meds it lowered to 19. Now it is rising again and they have advised an operation, how risk is he to being left totally blind?

  15. Dear Gordon,

    I really don’t have enough information to make a reasonable comment.

    Why was laser done, for what reason? What is his diagnosis? What operation is he advised?

    Randy

  16. This past April I had two retina surgeries. The first was in-office and the second was a hospital surgery that involved everything the doctor could do to my eye, from what he said. The second was necessary because about a week after the first surgery, I noticed that I couldn’t see as well and it turned out I had blood in my eye because my original surgery tore. Surgeon removed my lens during 2nd surgery. Went for 5 months without a lens and had one placed in my eye last Wednesday. Following the second surgery I had two problem that didn’t exist prior to the surgery: One is that I now have a darkened/gray area in my central vision. With the lens in, rather than the surrounding part of my vision being blurry, it now looks more in focus, but not correct. What I see seems to bend, is the closest way I can describe it. The other weird thing is that my eye does not seem to point straight. Instead, it looks like it points in a bit, sort of pigeon-toed. Had a follow-up appointment with my retina surgeon yesterday. Was told that the surgery can be viewed as a success because the goal was to reattach the retina. He also said that the surgery was quite traumatic on my eye and that is the reason for the problems that had appeared after the second surgery. He indicated that there was nothing else to be done and I am now stuck with poor vision. I had previously had an MRI to see if any cause was indicated related to the gray area in my central vision. Results were that everything looked fine. He had previously indicated that my macula looked fine and he had no idea what was causing that problem. Yesterday he stated that sometimes it takes a while for damage to show-up on a macula through change of color. I completely can’t understand why the surgery can be considered a success when I have problems after the surgery that definitely affect my vision, that were not present prior to the surgery. I asked for further action and he is trying to get me a referral to a neuro ophthalmologist. Can you suggest any further things to try or actions I should take? Some of this just doesn’t seem right to me. Just the same, I am not going to give up trying to get these problems solved. Thank you for any thoughts on my experiences and possible suggestions you may provide.

  17. Also had said previously that optic nerve was fine as observed by him and MRI.

  18. Dear Elizabeth,

    There are so many reasons why vision can be permanently reduced following “successful” retinal detachment surgery.

    I do not have an answer for you mainly due to the fact that I don’t know what happened during surgery and…I can’t examine you.

    It is heartening that the optic nerve and MRI (see additional comment submitted by Elizabeth).

    Your most recent surgery was just a week ago. Let’s be patient and re-evaluate in a month or so.
    This would not be unusual.

    r

  19. Dear Elizbeth,

    Please refer to your other comment posted at the same time.

    r

  20. Fagner Kisner says:

    Hello Doctor I am Brazilian and I have a displacement of vitreous in the right eye, the floaters bother me much, I have it for over 2 years, I am afraid to face the vitrectomy, my eyes are healthy and I see 100%, I’m 30 and would in your opinion and what are the chances of success, sorry my bad my English.

    Grateful

  21. Dear Fagner,

    Thank you for commenting.

    You should have no more fear than someone who wants cataract surgery. Vitrectomy is as safe or safer than cataract surgery. The two possible complications; blinding infection and retinal detachment are either less likely to occur in vitrectomy compared to cataract surgery or the same, ie. infection rates are much lower (1:10,000) with vitrectomy and retinal tears (about 1%) are the same.

    The chance of success, if you are sure the “floaters” move back and forth with eye movement, is almost 100%.

    Thanks for asking. Your English is awesome!

    r

  22. Hi Doctor,

    This is Srikanth from India, I’m planning to do LASIK surgery recently i met my doctor , he says my left eye having one week point. For me is it advisable to ungergo LASIK? and also tell me is LASIK is Safe?

  23. Dear Srikanth,

    I really can’t comment as I don’t know the reason for his making the statement about a weak eye.

    r

  24. Dr. Wong,

    I have a weiss ring in one eye and really bad floaters in the other. I’m really on the fence about a vitrectomy because I guess I should have it done on both eyes maybe a year or at least six months apart to see what happens. I’ve already had cataract and yag surgery so I’m not worried about that cataracts developing. I am a little concerned about maybe a retinal detachement since the weiss ring and the floaters actually developed after routine checkups. Will the weiss ring be any more of a challenge to remove than other floaters? It sure would be nice to have at least one “good” eye to see out of that is floater free.

  25. Dear Mike,

    PVD and Weiss ring go hand in hand and make the vitrectomy easy to perform. Weiss ring is a non-issue!

    r

  26. Hi Dr. Wong!

    I am 21 female, in Kansas, who has recently developed (6-7 weeks ago) a fair amount of eye floaters. This has made life unbearable.

    I have 2 large dark floaters in my eye and some clear ones in the right (not so bothersome).

    My Doctor said that surgery is not worth the risk. But, I really cannot continue life like this. I would like information on my risks and the cost for the procedure.

    Thank you.

  27. Dear Holly,

    Make sure to get examined. New floaters can be associated with retinal detachment or retinal tears.

    I’ll have Chrissy email you about visiting.

    Randy

    Randall V. Wong, M.D.
    Ophthalmologist, Retina Specialist
    Fairfax, Virginia

    http://www.TotalRetina.com
    http://www.RetinaEyeDoctor.com

  28. Cornell says:

    Dear Dr. Wong,

    I have been taking the following eye drops (Dorzolamide HCl-Timolol Maleate Opthalmic Solution – Cosopt 2 – 0.5%) for glaucoma in my right eye for about six years now , twice a day to reduce eye pressure. I just turned 37 years old. Every winter especially the most recent I noticed that I was having trouble dealing with the cold weather. All of a sudden my body became very sensitive to the cold weather. I would get sick very easily. This sensitivity to cold seem to get worse each after I started taking these drops. In addition, I would develop a lot of phlemg in my chest. I started to have a lot of resipiratory issues (trouble breathing, swallowing, etc.). Also, I have been having trouble sleeping, I would wake up tired, lethargic, nauseated, and sore muscles. I would have to sit for 30 minutes to a couple hours before the symptoms would leave. I did not have these symptoms prior to the eye drops. I finally realized that I may be having side effects from my eye drops. When, I read the label of the prescribed eye drops, all the symptoms that I was feeling were side effects labeled on the drops.
    I saw my family doctor and had several blood test to see what the problem maybe. Everything came back negative. The only thing I needed more of was vitamin D. The doctor stated that my symptoms we
    re probably coming from the eye drops. I stated this to my opthamologists and he gave me another eye drop (Alcon – Azopt brinzolamide ophthalmic suspension 1%) three times a day, to see if that will make a difference. I have been nervous to take it because I am still recovering from the side effects of the other one. Should I consider surgery since I am having reactions from the eye drops?

  29. Dear Cornell,

    Eye drops can certainly have significant effects to your body.

    I would first wait and see if switching drops is helpful. Beta blockers can be problematic.

    On the other hand, I am not a glaucoma specialist and am not sure what surgery you are considering.

    Stay in touch!

    Randy

    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, Virginia
    http://www.RetinaEyeDoctor.com

Trackbacks

  1. [...] risks of eye surgery – A Retina Eye Blog – Treatment can range from antibiotic injections, intravenous antibiotics and vitrectomy surgery. Retinal detachment is the second biggest risk of intraocular surgery. By operating inside the eye, an inadvertent retinal … [...]

  2. [...] eyes still remain one of the most unpredictable and often unstable body parts to treat, with the risks sometimes outweighing the benefits.  This is especially poignant when an eye specialist must deal [...]

  3. [...] of the most feared complications of eye injections is blindness.  This infection is called endophthalmitis.  Last week the FDA issued an alert the 12 cases of [...]

  4. [...] for floaters.  I recommend surgery if the opacities are bothersome, move to and fro and you understand the risks of surgery.  I prefer the floaters to have been present for several months.  After this time, they are [...]

  5. [...] loss of vision.  These two symptoms can be signs of either infection or retinal detachment, the two most dreaded complications of retinal surgery [...]

Speak Your Mind

*


Privacy Policy · Terms of Use

Search Engine Optimization by Medical Marketing Enterprises, L.L.C.