Editing Cataract (section)

==Prognosis==

=== Postoperative care ===
[[File:Anterior capsular opacification.jpg|thumb|[[Slit lamp]] photo of anterior capsular opacification visible a few months after implantation of intraocular lens, magnified view]]
[[File:Africa Partnerships Vision 2020 2 (10665602364).jpg|thumb|A South African woman experiences newfound eyesight after a patch was removed after surgery to remove an eye cataract.]]
The postoperative recovery period (after removing the cataract) is usually short. The patient is usually ambulatory on the day of surgery, but is advised to move cautiously and avoid straining or heavy lifting for about a month. The eye is usually patched on the day of surgery and use of an eye shield at night is often suggested for several days after surgery.<ref name=vaughan />

In all types of surgery, the cataractous lens is removed and replaced with an artificial lens, known as an [[intraocular lens]], which stays in the eye permanently. Intraocular lenses are usually monofocal, correcting for either distance or near vision. Multifocal lenses may be implanted to improve near and distance vision simultaneously, but these lenses may increase the chance of unsatisfactory vision.<ref name="yanoff" />

===Complications===
{{main|Cataract surgery#Complications}}
Serious complications of cataract surgery include [[retinal detachment]] and [[endophthalmitis]].<ref>{{citation |title=Applied Pathology for Ophthalmic Microsurgeons |page=247 |year=2008 |chapter=Complications After Cataract Surgery |veditors=Naumann GO, Holbach LM, Kruse FE |publisher=Springer Science & Business |isbn=978-3-540-68366-7}}.</ref> In both cases, patients notice a sudden decrease in vision. In endophthalmitis, patients often describe pain. Retinal detachment frequently presents with unilateral [[visual field]] defects, blurring of vision, flashes of light, or floating spots.{{citation needed|date=September 2022}}

The risk of retinal detachment was estimated as about 0.4% within 5.5 years, corresponding to a 2.3-fold risk increase compared to naturally expected incidence, with older studies reporting a substantially higher risk. The incidence is increasing over time in a somewhat linear manner, and the risk increase lasts for at least 20 years after the procedure. Particular risk factors are younger age, male sex, longer axial length, and complications during surgery. In the highest risk group of patients, the incidence of pseudophakic retinal detachment may be as high as 20%.<ref name=Herrmann_2011>{{cite journal | vauthors = Herrmann W, Helbig H, Heimann H | title = [Pseudophakic retinal detachment] | journal = Klinische Monatsblätter für Augenheilkunde | volume = 228 | issue = 3 | pages = 195–200 | date = March 2011 | pmid = 21374539 | doi = 10.1055/s-0029-1246116 | s2cid = 260192934 }}</ref>

The risk of endophthalmitis occurring after surgery is less than one in 1000.<ref>{{cite journal | vauthors = Behndig A, Montan P, Stenevi U, Kugelberg M, Lundström M | title = One million cataract surgeries: Swedish National Cataract Register 1992–2009 | journal = Journal of Cataract and Refractive Surgery | volume = 37 | issue = 8 | pages = 1539–1545 | date = August 2011 | pmid = 21782099 | doi = 10.1016/j.jcrs.2011.05.021 }}</ref>

Corneal [[edema]] and cystoid macular edema are less serious but more common, and occur because of persistent swelling at the front of the eye in corneal edema or back of the eye in cystoid macular edema.<ref>{{citation |title=Ophthalmology Secrets in Color |vauthors=Gault J, Vander J |page=221 |year=2015 |publisher=Elsevier Health Sciences |isbn=978-0-323-37802-4}}.</ref> They are normally the result of excessive inflammation following surgery, and in both cases, patients may notice blurred, foggy vision. They normally improve with time and with application of anti-inflammatory drops. The risk of either occurring is around one in 100. It is unclear whether [[nonsteroidal anti-inflammatory drug|NSAIDs]] or corticosteroids are superior at reducing postoperative inflammation.<ref name="Juthani">{{cite journal | vauthors = Juthani VV, Clearfield E, Chuck RS | title = Non-steroidal anti-inflammatory drugs versus corticosteroids for controlling inflammation after uncomplicated cataract surgery | journal = The Cochrane Database of Systematic Reviews | volume = 2017 | issue = 7 | pages = CD010516 | date = July 2017 | pmid = 28670710 | pmc = 5580934 | doi = 10.1002/14651858.CD010516.pub2 }}</ref>

Posterior capsular opacification, also known as after-cataract, is a condition in which months or years after successful cataract surgery, vision deteriorates or problems with glare and light scattering recur, usually due to thickening of the back or posterior capsule surrounding the implanted lens, so-called 'posterior lens capsule opacification'. Growth of natural lens cells remaining after the natural lens was removed may be the cause, and the younger the patient, the greater the chance of this occurring. Management involves cutting a small, circular area in the posterior capsule with targeted beams of energy from a laser, called [[Nd:YAG laser]] capsulotomy, after the type of laser used. The laser can be aimed very accurately, and the small part of the capsule which is cut falls harmlessly to the bottom of the inside of the eye. This procedure leaves sufficient capsule to hold the lens in place, but removes enough to allow light to pass directly through to the retina. Serious side effects are rare.<ref>{{cite web|url=http://www.rnib.org.uk/eyehealth/eyeconditions/conditionsac/Pages/cataract_lasersurgery.aspx|title=Posterior capsule opacification – why laser treatment is sometimes needed following cataract surgery|work=rnib.org.uk|url-status=live|archive-url=https://web.archive.org/web/20090917081625/http://www.rnib.org.uk/eyehealth/eyeconditions/conditionsac/Pages/cataract_lasersurgery.aspx|archive-date=2009-09-17|date=2014-02-19}}</ref> Posterior capsular opacification is common and occurs following up to one in four operations, but these rates are decreasing following the introduction of modern intraocular lenses together with a better understanding of the causes.{{citation needed|date=September 2022}}

[[Vitreous touch syndrome]] is a possible complication of intracapsular cataract extraction.<ref>{{cite web| vauthors = Banerjee K |title=A review and clinical evaluation of per-operative and post-operative complications in case of manual small incision cataract surgery and extracapsular cataract extraction with posterior chamber intra-ocular lens implantation|url=http://14.139.159.4:8080/jspui/bitstream/123456789/1638/1/CDMOPTH00032.pdf|access-date=1 June 2014|date=2006|url-status=dead|archive-url=https://web.archive.org/web/20140605064801/http://14.139.159.4:8080/jspui/bitstream/123456789/1638/1/CDMOPTH00032.pdf|archive-date=5 June 2014}}</ref>