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Cataract surgery safer now

Serious, potentially blinding complications from cataract eye surgery are uncommon, and have been declining since the 1990s.

Cataract surgery safer now

Serious, potentially blinding complications from cataract eye surgery are uncommon, and have been declining since the 1990s.

A cataract is a clouding of the eye's lens, usually caused by clumping of the proteins in the lens as a person ages. Cataract removal is the most common type of surgery in the US, with more than 3 million procedures done each year. While the surgery is generally considered safe, there can be sight-threatening complications - including severe inflammation in the eye, bleeding, and detachment of the retina (the light-sensing tissue coating the inside of the eye). But these problems are uncommon and appear to be waning.

Researchers studied Medicare patients who had cataract surgery in 2005 or 2006, and found that four out of every 1000 had at least one serious complication in the year following the surgery. This compared with six out of every 1000 a decade earlier, in 1994 and 1995. When the researchers took risk factors for complications into account - including having other chronic health conditions - people who had surgery in the mid-1990s were 21 percent more likely to have a serious complication than those who had surgery in recent years.

The analysis confirmed that cataract surgery is a safe surgical procedure with low risks of severe adverse events, and that the safety profile of this procedure has continued to improve over the past decade.

These days, cataract removal is usually done via a technique called phacoemulsification. The surgeon makes a small incision in the eye's outer membrane, then inserts a tiny probe. The probe emits sound waves that break up the lens, which is then suctioned out and replaced with an artificial lens. The same type of procedure was also done in the 1990s. But improved equipment and instruments may largely explain the decline in severe complications. There are, though, certain patients at relatively higher risk of complications from cataract surgery. They included patients with proliferative diabetic retinopathy - an advanced stage of diabetes-related damage to the tiny blood vessels of the retina. While their risk of severe complications was still low, it was 62 percent higher than in patients without proliferative diabetic retinopathy. This suggests that when people with diabetic retinopathy have cataracts, it might be better to consider surgery sooner rather than later - before the retinopathy gets worse. Patients having certain other eye procedures at the same time as cataract surgery were also at high risk of complications.

Further studies are needed to look into ways to further reduce surgery complications in high risk patients.
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