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How safe is cataract surgery?

older woman with cataracts wondering if cataract surgery is safe

Cataract surgery is a very safe and successful medical procedure. In the United States, about 4 million cataract surgery procedures are performed every year. In fact, a study of over 221,000 cataract surgery patients found that 99.5% of patients had no serious complications after surgery. 

Like any type of surgery, cataract removal poses risks that are important to know so you can make an informed decision. 

Why is cataract surgery so safe?

An ophthalmologist performs cataract surgery to restore a patient’s cataract-related vision loss. During the procedure, the surgeon replaces the clouded lens inside the eye with a clear artificial lens called an intraocular lens. They do this using advanced surgical tools and proven techniques.  

The entire surgery typically takes about 15 to 20 minutes and is usually pain-free. The incisions made in the eye are so small that stitches are often not needed. Eye drops are used for anesthesia, which means the patient only needs a small amount of sedation to relax. Antibiotics are given before and after the procedure to reduce the risk of infection.  

To enhance safety, cataract surgery is typically only performed on one eye at a time, though there are exceptions when both eyes are operated on at the same time. This gives the first eye time to recover, and a few weeks later, the second eye will be treated. This way, the eyes are not put at risk at the same time.

As with any surgery, cataract surgery has some risks, such as bleeding, infection and other complications. 

Is cataract surgery safe if you are older?

In most cases, cataract surgery is safe if you are older, but the risk of complications does increase with age. Even so, cataract surgery can improve quality of life and reduce other risks related to poor vision, such as: 

  • Tripping and falling 

  • Fracturing a bone

  • Car accidents 

In patients over 85, about 85% had improved vision, and 87% felt they benefited from the surgery. 

Even for individuals over age 90, cataract surgery was found to benefit health and longevity. Although the very old have more health problems, they can still benefit from cataract surgery. It allows them to better handle day-to-day activities. Surgery can also improve their social life and even extend their life expectancy. 

Is cataract surgery safe if you have a heart or lung condition?

Most of the time, even if you have a heart or lung condition, cataract surgery is safe. That’s because cataract surgery is a quick, low-risk procedure. Typical cataract surgery uses local anesthetic and mild sedation to help you relax, so it doesn’t carry the risks associated with general anesthesia.

Even so, your primary care doctor or internist is likely to run some routine tests, including blood tests and an EEG to see how your heart is functioning. These tests will allow your doctor to take special care if there is any condition.

If you have diabetes, it’s a good idea to ensure your retina (in the back of the eye) is healthy enough for cataract surgery. Your doctor will also want to make sure your blood sugar is well-controlled.  

Is cataract surgery safe and effective if I have other eye diseases?

Eye diseases are more common as you age. Some of these conditions, such as glaucoma and macular degeneration, can make cataract surgery more challenging or change your vision expectations after cataract surgery. 

Even if another condition is present, cataract surgery can often be performed safely and successfully. Sometimes, doctors will treat both the glaucoma and the cataract at the same time. They can do this by implanting an artificial lens as well as a tiny stent that helps fluid in the eye drain properly.

If you have macular degeneration, your doctor will ensure the condition is stabilized before surgery. Studies have shown that cataract surgery does not speed the progression of macular degeneration.

Future of cataract surgery seems promising. Ocular Surgery News. February 2021.

Severe adverse events after cataract surgery among Medicare beneficiaries. Ophthalmology. September 2011.

Cataract. American Optometric Association. Accessed August 2021.

Laser cataract surgery faqs.  Kellogg Eye Center, University of Michigan. Accessed September 2021.

Changing techniques in cataract surgery: How have patients benefited? Community Eye Health. 2017

Is cataract surgery safe for patients above 65 years of age? American Academy of Ophthalmology. February 2014.

Efficacy of intracameral moxifloxacin endophthalmitis prophylaxis at Aravind Eye Hospital. Ophthalmology. February 2016.

Cataract surgery in patients older than 90 years. Ocular Surgery News. July 2018.

Effect of increasing age on cataract surgery outcomes in very elderly patients. BMJ. May 2001.

Results of cataract surgery in the very elderly population. Journal of Optometry. July-September 2009.

Medical tests before eye surgery. Choosing Wisely, ABIM Foundation. Accessed September 2021.

Glaucoma and cataracts. Eye Center of Texas. July 2020.

Can I have cataract surgery if I have macular degeneration? Northshore Eye Care. April 2020.

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