Cloudy Vision After Cataract Surgery

Cataract surgery has come a long way over the years and the surgical results are dramatically better then in the past. However, there are still potential complications and careful presurgical evaluations can often predict post surgical complications. One such potential problem is corneal edema (swelling of the cornea).

With the development of Phacoemulsification which involves vibrations that break apart the cataractous lens, the likelihood of corneal swelling is much greater. In the hands of an experienced cataract surgeon, this side effect should be minimized, but there are certain ocular conditions that may still results in substantial post surgical corneal edema.

A very dense cataract will require a longer and more intense time period to break apart the lens; thus increasing the intraocular vibrations. This will in turn result in more swelling within the eye. Likewise a shallow anterior chamber (the area between the iris and the cornea) will result in more post surgical swelling. This decreased distance permits more of the shock waves from the phaco instrument to reach the endothelial layer (back layer) of the cornea resulting in more swelling. All pre-existing corneal disease will weaken the cornea and therefore result in more post surgical edema; the worse the disorder, the more the swelling. Finally, viscoelastic fluid from the surgery may clog up the drainage areas thus resulting in high post surgical intraocular pressures. This in turn will cause the cornea to become swollen.

In short, proper presurgical evaluations can often predict post surgical corneal swelling. While this should not be a contraindication for the surgery; expecting this side affect will make the follow up care better and permit more complete patient instructions. It will also allow the patient to have more accurate expectations post surgically.