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]](http://img.zemanta.com/reblog_e.png?x-id=6b44d8e1-a3b5-42f3-ba99-59ec65d9b90d)
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
Fairfax, Virginia
***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.***
Great info! Teri
Thanks for commenting. Too many people think eye surgery is risk free. It is pretty safe, but not guaranteed.
Randy
Thanks Doc,
You give us floater sufferers hope, even all the way over here in Australia!
Regards
Jake
Dear Jake,
Thanks for the comment!
All the best!
Randy
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
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.
Dear Rocky,
What are you talking about? What kind of eye surgery?
r
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.
Good luck next week. I think it is only in your best interest.
Randy
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?
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
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?
Dear Teri,
Sounds weird. I’d ask your doc the same question.
r
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?
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