What Your Cataract Surgeon Never Told You | FIVE Common *Secret* Side Effects Of Cataract Surgery!

Summary

Dr. Michele Lee, an ophthalmologist, discusses cataract surgery and its potential complications. She reveals five lesser-known aspects: dry eyes, which affect 42% of patients post-surgery; ptosis, or droopy eyelids, occurring in up to 21% of cases; dysphotopsias, causing unwanted visual disturbances; increased floaters due to vitreous detachment; and secondary cataracts from scar tissue, treatable with a YAG laser. This video aims to inform patients about these common yet under-discussed post-surgical experiences.

Takeaways

• 👨‍⚕️ Dr. Michele Lee is a board-certified ophthalmologist who performs cataract surgery.
• 👀 Cataracts are a common age-related condition where the eye's lens becomes cloudy.
• ⚠️ Cataract surgery carries risks including complications, prolonged inflammation, infection, and the need for additional surgery.
• 🌟 Many patients experience life-changing improvements in vision after cataract surgery.
• 👁️‍🗨️ Post-surgery, 42% of patients report dry eye symptoms, often due to eye drops, inflammation, or corneal nerve damage.
• 😓 Droopy eyelids, or ptosis, can affect up to 21% of patients post-surgery and may be due to the use of an eyelid speculum during surgery.
• 🤔 Dysphotopsias, or unwanted optical images, can cause dissatisfaction post-surgery but often resolve over time.
• 🌈 Floaters may become more noticeable after cataract surgery due to vitreous detachment or post-surgical inflammation.
• 🛡️ Some patients develop scar tissue behind the new lens, requiring a YAG laser treatment to clear vision.
• 👍 The YAG laser treatment for secondary cataracts is quick and effective, with no need for repeat treatments.

Q & A

What is a cataract?

A cataract is a clouding of the eye's lens, which can impair vision and typically develops over time.

What are the common risks discussed during a cataract surgery consultation?

The common risks discussed include complications, prolonged inflammation, infection, and the possibility of needing additional surgery.

Why do patients often wish they had cataract surgery sooner?

Patients often express this sentiment because the surgery can be life-changing, significantly improving their vision and quality of life.

What percentage of patients reported dry eye symptoms after cataract surgery according to the survey study mentioned?

42% of patients reported experiencing dry eye symptoms after cataract surgery.

Why are eye drops used after cataract surgery potentially contributing to dry eyes?

The eye drops used post-surgery often contain preservatives that can dry out the eyes, contributing to dry eye symptoms.

What is ptosis and how is it related to cataract surgery?

Ptosis, or droopy eyelid, is an overlooked side effect that can occur in up to 21% of patients after cataract surgery, possibly due to the use of an eyelid speculum during the procedure.

Why should someone considering eyelid surgery postpone it until after cataract surgery?

Cataract surgery can exacerbate pre-existing droopy eyelids, making it important to address cataracts first to avoid complications with eyelid surgery.

What are dysphotopsias and how are they related to cataract surgery?

Dysphotopsias are unwanted optical images, such as arcs of light or shadows, that can result from the design of the intraocular lens implanted during cataract surgery.

What is a common cause of increased floaters after cataract surgery?

A common cause is the occurrence of a vitreous detachment, which is the separation of the vitreous gel from the retina, leading to an increase in floaters.

What is the term for the scar tissue that can form behind a new intraocular lens and how is it treated?

The scar tissue is referred to as a 'secondary cataract' and is treated using a YAG laser, which can clear the tissue and restore vision.

Why might a patient need a laser treatment after cataract surgery?

Patients might need a laser treatment to remove scar tissue that can form behind the new intraocular lens, which can cause symptoms similar to a cataract, such as glare, decreased vision quality, and blurry vision.

Outlines

00:00

👁️ Cataract Surgery: Risks and Common Complications

Dr. Michele Lee, a board-certified ophthalmologist, discusses cataract surgery and its associated risks. Cataracts are a common age-related clouding of the eye's lens, and while surgery is life-changing, it comes with potential complications such as prolonged inflammation, infection, and the need for additional surgeries. The video aims to reveal five lesser-known aspects of cataract surgery. Notably, nearly half of the patients experience dry eye symptoms post-surgery due to the use of preservative-containing eye drops, inflammation, and corneal nerve damage. Another overlooked effect is ptosis, or droopy eyelids, which can affect up to 21% of patients and may be exacerbated by the use of an eyelid speculum during surgery. Unwanted optical images, or dysphotopsias, can also occur, causing visual disturbances like arcs of light or shadows. Lastly, floaters may become more common after surgery due to vitreous detachment or post-surgical inflammation.

05:02

🌟 Post-Cataract Surgery: Floaters and Secondary Cataracts

The second paragraph delves into the prevalence of floaters following cataract surgery, which can be caused by vitreous detachment or inflammation. It also addresses the issue of secondary cataracts, which are scar tissues that form behind the new lens and can mimic the symptoms of cataracts, such as glare and blurry vision. These can be effectively treated with a YAG laser, a quick and instantaneous procedure that resolves the issue permanently. The video concludes with a call to action for viewers to like and subscribe for more informative content.

Keywords

💡Cataract

A cataract refers to a clouding of the eye's natural lens, which can impair vision. In the context of the video, cataracts are described as 'dirty lenses inside the eye' that develop over time. The video's primary focus is cataract surgery, which is a procedure to remove the cloudy lens and replace it with an artificial one, aiming to restore vision.

💡Cataract Surgery

Cataract surgery is a medical procedure to treat cataracts by removing the cloudy lens and replacing it with an intraocular lens. The video discusses the life-changing impact of this surgery, highlighting the improved vision many patients experience post-operation, but also the potential complications and side effects that surgeons may not fully discuss pre-surgery.

💡Complications

Complications in the context of the video refer to the adverse outcomes or issues that can arise following cataract surgery. These may include prolonged inflammation, infection, and the need for additional surgery. The video emphasizes the importance of being aware of these potential issues, as they are part of the risks associated with the procedure.

💡Dry Eyes

Dry eyes is a common condition where the eyes do not produce enough tears to keep them lubricated. In the video, it is mentioned that 'everybody has some degree of dry eyes after cataract surgery,' with 42% of patients reporting dry eye symptoms post-surgery. This is linked to the use of eye drops with preservatives and inflammation after surgery, which can exacerbate dryness.

💡Inflammation

Inflammation is the body's response to injury or infection and is characterized by redness, heat, swelling, and sometimes pain. The video discusses how inflammation is common after cataract surgery and can lead to dry eye symptoms. It is also noted that inflammation on the ocular surface can worsen after stopping anti-inflammatory eye drops post-surgery.

💡Ptosis

Ptosis, also known as a droopy eyelid, is a condition where the upper eyelid droops. The video points out that this can be an overlooked side effect of cataract surgery, occurring in up to 21% of patients. It can be a reaction to post-surgical dry eyes or due to the stretching of the eyelids by the surgical speculum used during the procedure.

💡Dysphotopsias

Dysphotopsias are unwanted optical images that some patients experience after cataract surgery. These can manifest as arcs of light, shadows, or darkness in the field of vision. The video explains that these phenomena are related to the design of the intraocular lens and, while bothersome, most patients adapt to them over time.

💡Floaters

Floaters are specks or shapes that appear to float across the field of vision and are often more noticeable against a bright background. The video mentions that floaters are extremely common after cataract surgery, possibly due to vitreous detachment or post-surgical inflammation, which can cause a temporary increase in these visual disturbances.

💡Vitreous Detachment

Vitreous detachment is a condition where the gel-like substance (vitreous) inside the eye separates from the retina. The video suggests that cataract surgery can trigger this event, which often leads to the appearance of floaters and a slightly increased risk of retinal tears or detachment.

💡YAG Laser

The YAG laser is a type of laser used in ophthalmology to treat certain eye conditions. In the video, it is mentioned as a treatment for scar tissue behind the new intraocular lens, which can cause symptoms similar to cataracts. The YAG laser treatment is described as quick and effective, with no need for repeat treatments once performed.

Highlights

Cataract surgery is life-changing and can significantly improve vision.

There are inherent risks and complications associated with cataract surgery.

Nearly all patients experience some degree of dry eyes after cataract surgery.

42% of patients reported dry eye symptoms post-surgery.

Post-surgery eye drops with preservatives can contribute to dry eyes.

Inflammation after cataract surgery can lead to dry eye symptoms.

Corneal nerves may be cut during surgery, affecting tear production and blink reflex.

Droopy eyelid or ptosis can occur in up to 21% of patients post-surgery.

Droopy eyelids may be a reaction to post-surgery dry eyes or due to the use of an eyelid speculum.

Cataract surgery can exacerbate pre-existing droopy eyelids.

Upneeq eye drops can provide a temporary fix for droopy eyelids.

Dysphotopsias, or unwanted optical images, are a common cause of patient dissatisfaction post-surgery.

Dysphotopsias can manifest as arcs of light or shadows in the field of vision.

Lens design improvements aim to reduce dysphotopsias.

Floaters become more common after cataract surgery due to various factors.

Vitreous detachment, which can cause floaters, often occurs after cataract surgery.

Post-surgical inflammation can cause a temporary increase in floaters.

30-50 percent of eyes may require laser treatment for scar tissue behind the new lens.

Scar tissue symptoms resemble cataracts and can be treated with a YAG laser.

YAG laser treatment for scar tissue is quick and effective, with no need for repeat treatments.

Transcripts

Hi, I’m Dr. Michele Lee, a  board-certified ophthalmologist.  

As part of my practice, I  perform cataract surgery.

Cataracts are dirty lenses inside the eye  that nearly everyone will develop over time,  

and when I see my patients for  a cataract surgery consultation,  

we talk extensively about the risks of  cataract surgery including complications,  

prolonged inflammation, and infection,  as well as the risk of needing additional  

surgery as a consequence of surgery. To be  clear, cataract surgery is life-changing.

I can’t tell you how many happy patients  I see after surgery and how many times  

they tell me that they wish  they did the surgery sooner.

However, there are so many possible complications  and side effects that can come up after surgery  

that your surgeon could not possibly sit with you  for hours and go through every single scenario.

So in this video, I want to reveal to  you the 5 things that you might want  

to know about your cataract surgery that  your cataract surgeon, including myself,  

probably did not tell you before your surgery.

Everybody has some degree of  dry eyes after cataract surgery  

and 42% of patients in a survey study  reported dry eye symptoms after surgery.

There are many reasons why.

First of all, the eye drops that  we use after cataract surgery  

typically include bottled drops with  preservatives that can dry out the eyes.

Also, Inflammation is very  common after cataract surgery.

Inflammation on the ocular surface  is a very common cause of dry eye,  

and this type of dry eye typically gets worse  

after you stop your anti-inflammatory  eye drops a few weeks after surgery.

Finally, some of the cornea  nerves are cut during surgery,  

which results in loss of corneal sensation.

Corneal sensation is responsible  for promoting tear production,  

causing the blink reflex, and  producing growth factors for healing.

Droopy eyelid, which is also called  ptosis, is an overlooked side effect  

of cataract surgery that can occur in  up to 21% of patients after surgery.

Sometimes, droopy eyelids are a reaction to dry  eyes which develop after cataract surgery and  

resolve as the eye goes back to normal, but  sometimes this droopiness can be persistent.

This is most likely due to the eyelid  speculum that we use during cataract  

surgery to open the eyes that, while  necessary, can stretch out your eyelids.

If you already have droopy eyelids,  cataract surgery will make it worse.

If you are considering eyelid surgery,  

you will want to postpone this until  after you have cataract surgery.

If you need a temporary fix before eyelid surgery,  

you can consider Upneeq, a daily eye drop that can  help with droopy eyelids for short-term results.

A common cause of patient dissatisfaction after  

cataract surgery are unwanted optical  images, also known as dysphotopsias.

You can have positive dysphotopsias, which can  look like an arc of light on the side of the  

vision, or a negative dysphotposia, which is a  shadow or darkness on the side of the vision.

These are related to the design of the lens  that is put in the eye to replace your cataract,  

and while our lens designs improve every  year, many patients still experience this.

For the most part, these symptoms can  disappear weeks to months after surgery.

While bothersome, most people learn to adapt to  this phenomena. If dysphotopsias are bothersome  

and disruptive, your doctor can consider  various pupil constricting eye drops or glasses.

Very infrequently, your doctor could consider  exchanging the lens to a different type of lens  

but this type of surgery, an  intraocular lens exchange,  

is extremely risky and must be approached  cautiously and as a last resort.

Floaters are extremely common - more common than  

you might think - and often appear  more often after cataract surgery.

There are quite a few reasons why you  get floaters after cataract surgery.

If you have not undergone an event called a  vitreous detachment, which is a separation  

of the vitreous, or jelly that fills the  inner part of the eye, to the retina,  

the vascular wallpaper of the eye,  you certainly will after surgery.

This event frequently causes  floaters and puts you at  

a slightly increased risk of  a retinal tear or detachment.

Another common reason for more  floaters is that after surgery,  

eye inflammation inside the post-surgical eye  

can also appear like “floaters” in your vision  and may cause a temporary increase in spots.

Everyone develops some degree of  scar tissue behind the new lens  

inside the eye, and 30-50 percent of eyes end  up requiring a laser to get rid of this tissue.

This can start appear early as the  day of surgery to many years later.

The scar tissue is also called  a “secondary cataract” because  

symptoms are very similar to cataracts.

The first symptoms are nighttime  glare, decreased quality of vision,  

followed by overall blurry vision.

Thankfully, treatment is quick  

and performed using a laser called a  YAG laser, and works instantaneously.

Once you have this treatment,  you never have to have it again.

I hope you found this video helpful. If you  enjoyed this video, please like and subscribe,  

and I’ll see you in my next video. Bye!