Cataract surgery failure

I’ve heard that not all cataract surgeries are successful. I’m assuming that there’s nothing wrong with the new lens itself, so there must be other factors that can go wrong. What are they?

My mother had what could be considered as a failed cataract surgery as afterwards, she experienced tunnel like dual vision in her eye. Fortunately, only one eye was operated on and she refused to have anything done to the other.

The reason(s) for this result are speculative and may be associated with a reported equipment malfunction during the operation or perhaps an unusual and unanticipated physical oddity with her eye. Either that or the doctor simply screwed up.

What kind of cataract surgeries are you talking about? There are several different types of operations in common use today, and several more that have been historically used—cataract surgery has been around for thousands of years. Not all procedures involve a new lens.

Any cataract surgery which involves manipulating the eye with a tool runs the risk of damaging the eye with the tool (for example, by cutting or poking it). Infection is also a danger. Without further details about the kind of surgeries you’re interested in it’s probably difficult to speculate more precisely as to exactly what could go wrong.

IANAD. I had cataract surgery myself last week, and so far I’m happy with the results, but with any kind of surgery there is a risk that something could go wrong.

As others have noted, it could be anything from the doctor making a bad incision to the patient not properly following the post-op regimen of antibiotics and other precautions.

Anything you do in this life has some non-zero risk of failure attached to it. If you are considering having surgery, discuss with your doctor what the risks are and make an informed decision. Ask how many surgeries of this type he has performed and how many years he has been practicing.

My late wife had cataracts in both eyes, and because of possible complication due to her diabetic retinopathy they decided to operate on her worse eye first, on the theory that if something went wrong she’d have the best possible vision. The surgery went well, and after what they considered a reasonable period they operated on her second eye.

Unfortunately, after the second surgery there were complications, not only with the second surgery but also with the first, and she ended up being legally blind.

My grandmother also had complications. Her surgery required new lenses, and it was found out after the fact that during manufacturing, the lens in one eye hadn’t been rinsed properly. The microscopic particles of metal that were clinging to the lens subsequently caused a lot of scarring and she’s lost a lot of vision in that eye.

She was understandably very gunshy about getting the surgery on the other eye, but IIRC that surgery went exactly as planned and was successful. Still, she’s lost a lot of capabilities because of her damaged eye - she can’t craft as much anymore, nor drive, those types of things. (However, she is 83 - perhaps it’s not a bad thing that she can’t drive!)

If it is a failure, it is your problem according to Insurers of the Physicians. Unfortunately, there is a high degree of success which overshadows the erros that can be made;

.e.g. Digitial Massage of the eyeball during the block procedure if it is too long or done with too much pressure. However, since these physicians have no official standards they learn it by “trial” and error.

e.g. the Injection that is put into the eye for the block procedure can nip the optic nerve Once the Optic Nerve goes pale (or has a stroke as they like to call it) that’s it, the central eyesight is gone.

Of course, since insurers are involved and physicians can do no wrong they don’t tell you about all the things that you will be blamed with (i.e. the real risks) if something goes wrong.

Sure, they might mention detached retina can and does occur after cataract sugery but allegedly that is straightforward to correct…

however, if you develop Retinal Vein Occlusion (i.e. Killed the Optic Nerve) as a result of cataract surgery, you will be blamed regards of surgeon’s error which they will never admit! :mad:

They will blame Diabetes, Smoking, Too much fat in the blood, cholesterol, hypertension, and when those fail “Spontaneous occlusions occur even without surgery and surgery can increase the risk”.

Too many people, as I did, procede recklessly based on the high % of success and the Surgeions are so full of themselves (and a bag of chips) they consider it routine and fail to adequately test for anything that can cause a problem.

When that fails that will point to the Cartoid Arteries as must having been the problem. So get that tested before Surgery!

Since there are no Studies of Time & Pressure during digital massage the Surgeons can and have caused loss of eyesight but get away scot free because there is “no standard of care” that can make them accountable.

My surgeries were in 91 and 92. Both artificial lenses have moved. This condition didn’t start until 10-12 years later. One lens is way out of place and will need another surgery to relocate and anchor plus burnout the clouded membrane behind it.

The clouded membrane behind the new lens is common, not really a failure of the cataract surgery itself. The correction to this condition involves a laser focused on the membrane that burns a hole through it. It’s simple out-patient surgery with almost no recovery time.


They cut into your eyeball without anesthesia?!?

Yup. The oldest procedure is called “couching” (from the French “coucher”, which means “to lay down”), which involves using a curved needle to knock the lens out of its usual place. Lens falls down to the base of the eye and no longer blocks the path of light to the retina. Obviously no replacement lens is implanted - the first effective intraocular lenses were only developed in the last 50 years. This is better than having your field of view entirely blocked by a cataract, but not by that much.

It’s not exactly a huge cut, you just poke the lens with a curved needle. Nervewracking, but pretty fast and (reasonably) effective. Been around for millenia.

Cataract surgery has improved in recent years. Although there still is a possibility of untoward consequences, the chance of that, IMHO, is now very slim. IANAMD, but I did have access to a journal for opthalmologists which discussed various options available now. I should be having cataract surgery soon, with little hesitation.

I just want to remind us all that there are deadening drops for any procedure like this. Also, “what if” they make another error? Hopeless?

And a Question, could they accidentally nick your optic nerve doing a Kenalog injection? The first time I had one, years ago, I don’t remember having to wait three days for a web (blood vessels?) of black medication to drain out, or a feeling of having a bubble in the lower part of my eye. Would I have been wiser to see my Primary Care Dr. for some eye swelling, for an over-all antibiotic? Less risk of injury, right?

Not really. There’s deadening drops.

My first zombie thread! A new milestone!

I was referring to how the procedure used to be done in the pre-modern era. It’s certainly not done this way nowadays - I don’t think couching is even used anymore, much less without anesthesia. If someone suggests doing surgery on your eyeballs sans anesthesia, I’d recommend getting a second opinion. And then a third one.

Wow, so many lies, so short an existence!
First, if it is a failure, legal action CAN be successful, IF it is the fault of the surgeon or even the lens vendor.

Digital Massage is risky, it literally means rubbing the eye with fingers, something people do every day and occasionally detach a fragile retina that typically has some other disease causing the excessive fragility. The surgeon is not trying to gouge patients eyes out!

NO injection for cataract surgery can “nick the optic nerve”. PERIOD, the lens is at the front of the eye, the optic nerve is BEHIND the eye, an inch and change away. Optic nerve damage IS known to occur, secondary to increased intraocular pressure, essentially a brief case of glaucoma of excessive form.

The typical idiocy of the evil insurances and physicians. Really, if you don’t trust them, go blind. Just don’t try to get disability for what you could have prevented.

Retinal detachment IS a more commonly reported problem, though it’s not COMMON. The retina bleeds, which means something caused damage, typically age related issues that weakened the blood vessels. There are several procedures that have high success rates in treating the problem.

Retinal vein occlusion is NOT a killed optic nerve, hence why it’s called a RETINAL VEIN occlusion. In short, a stroke of the retina. Some people can get that, as well as a retinal detachment, from merely rubbing their eyes. I’m personally a prime candidate for either, due to significant lattice degeneration. Retinal vein occlusion means that a vein in the RETINA is blocked, so blood cannot flow through the retina and it dies, depending on the location of the blockage, the severity is variable. Small area vs large area thing.

The evil people will blame diabetes, smoking, etc… Yep! Diabetes weakens blood vessels. Smoking (I personally smoke a pack a day of Lucky Strikes) raises blood pressure. Cholesterol is linked to vascular disease, you remember, when those arteries get hard and fragile? But, you’re right. All of those blind people who had the same issues WITHOUT eye surgery don’t exist. They’ll feel happy to know that they don’t exist, I’m sure.

I find it fascinating that you know what will be “blamed” next! Now, you’re psychic AND psycho. Incredible combination.

Surgeons don’t just pick up a knife and start carving. They are TRAINED. As in things like residency. As in specialty training. That is like saying there is no studies on time and pressure on suturing a major blood vessel!

Sorry folks, but THESE types of posts REALLY push my start button. As I said previously, lies, lies and more lies.
Indeed, the lunacy of hitting the optic nerve with a needle is on the order of having a laproscopic procedure for a gallbladder and the surgeon striking the patient’s spinal cord with the trochar!

To the original question, the following have been observed infrequently in patients having cataract surgery:
Elevated intraocular pressure causing a “stroke” of the retina
Retinal detatchment
Dislodged intraocular replacement lens
Incorrectly positioned intraocular replacement lens
Damage to the iris or eye itself due to surgical error
Infection (which is why the patient is given post operative antibiotics and anti-inflammatory drops)

Frequently, the posterior lens capsule will become opaque, causing similar symptoms to a cataract, this is easily corrected in office with a laser removing part of the opaque posterior lens capsule (hanged if I know WHY they don’t remove it while they’re removing the lens)

The list of complications is normally given to the patient before surgery and on paper after as well, with warnings to go to the hospital IMMEDIATELY if they have a list of certain symptoms (such as an area of vision going dark, flashes of light, significant pain and a few other symptoms.

I personally have had one lens replaced, another eventually will have to be done. I’m getting some issues with the posterior lens capsule now, but lacking a job and insurance, I can’t afford that $1500 laser “zap” to fix it and it isn’t significant at this time.
My biggest impact was looking around and realizing that for years, I didn’t see very much of the color BLUE!

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Personal insults (including calling other posters liars) are not allowed in the GQ forum. Do not do this again.
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a few years ago I had an unsuccessful cataract surgery. A day after the surgery I saw numerous black spots in my vision. At my follow up with the sugeon, he said it was very unusual for that to happen but does occur a few times out of a hundred he does each year. He had me see a retina specialist who would be required to perform another surgery that was expected to be successful to get rid of the spots but the cataract surgery was not going to be successful. I don’t know what the name of or the reason for my result. But the clearing of the spots was good. My vision is poor from the eye but no worse than it was before the surgery. I ended up being fitted for a contact lens for the one eye, after about 10 visits but I never used the contact lens after a few months. Too much trouble. I did have cataract surgery a couple years later with another surgeon and that one has been good. I am now 77 years old and wear glasses with one eye at about 20/25 and the other is poor and cannot be corrected with glasses but was poor before surgery. Anyone understand what actually happened and why? I never was told more than it does occur at times.

Excellent suggestion, “Ask what the risks are.” And re your expression, “doctor making bad INCISION”, has anyone heard that there should always be a stitch to hold the implant lens in place? Is it possible the doctor might make the capsule a hair too large? How can we know if the implant has slipped or something?

So sorry for you poor vision. Are you able to pass your driving test?