Can Cataract Surgery Lead to Floaters? Post-Operative Risks

Cataract surgery. If the doctor operates carelessly, can it lead to floaters?

Hello Dr.
Wang.
Before the surgery, I did not have myopia and had no history of floaters.
I also did not need reading glasses to read the newspaper.
My right eye had mild cataracts, which were not severe enough to cause overlapping text when watching TV.
However, my vision was 0.8 in the left eye and 0.4 in the right eye, so I decided to have surgery on the right eye to balance my vision.
After the surgery, my eye became congested, and the surgeon said this was a normal reaction.
On the third day post-surgery, I experienced floaters, which appeared like a sky full of stars.
It has been two years, and there has been no improvement.
Could you please explain why this phenomenon occurred? Is it due to post-operative inflammation causing the floaters, or could it be that some fragments of the lens were not completely removed during the surgery, leading to vitreous opacities? I would greatly appreciate your clarification on this matter.
Thank you, Dr.
Wang.

Shuhui, 60~69 year old female. Ask Date: 2016/03/27

Dr. Wang Zhishun reply Ophthalmology

Hello, there could be many possible reasons.
It may be that the cataract was obstructing the floaters before the surgery, or the surgery itself may have triggered them.
Additionally, the situation you mentioned is also possible.
I recommend consulting with a physician for further examination.

Reply Date: 2016/03/27

More Info

Cataract surgery is a common procedure aimed at improving vision by removing the cloudy lens of the eye and replacing it with an artificial lens. While it is generally safe and effective, patients may experience a range of post-operative symptoms, including the development of floaters, also known as "muscae volitantes."
Floaters are small spots, specks, or cobweb-like images that drift across your field of vision. They are typically caused by changes in the vitreous gel that fills the eye, which can occur naturally with aging or as a result of various eye conditions. In your case, the appearance of floaters after cataract surgery raises several important considerations.

Firstly, it is essential to understand that the development of floaters post-surgery can be attributed to a few factors. One possibility is that the surgery itself can lead to changes in the vitreous gel. During cataract surgery, the eye is manipulated, and the vitreous may be disturbed, leading to the formation of floaters. This is particularly common in patients who have not previously experienced floaters, as your case suggests.

Another potential cause for the floaters could be related to inflammation following the surgery. Post-operative inflammation is a normal response as the eye heals, and it can sometimes lead to changes in the vitreous that result in floaters. If the inflammation is significant, it may also cause other symptoms, such as redness or discomfort, which you mentioned experiencing as "eye congestion."
Additionally, there is a possibility that small fragments of the cataract lens, known as lens material, could remain in the eye after surgery. If any of this material were to migrate into the vitreous cavity, it could lead to visual disturbances, including floaters. However, this scenario is relatively rare, especially with modern surgical techniques that aim to ensure complete removal of the cataract.

In your situation, since you have been experiencing floaters for two years without improvement, it is advisable to consult with your ophthalmologist for a thorough examination. They can assess the condition of your vitreous and determine if there are any underlying issues that need to be addressed. In some cases, floaters may diminish over time, but if they significantly impact your quality of life or vision, your doctor may discuss potential treatment options, such as vitrectomy, which involves removing the vitreous gel and the associated floaters.

In conclusion, while cataract surgery can lead to the development of floaters, the exact cause in your case may be multifactorial, involving changes in the vitreous gel, post-operative inflammation, or the presence of residual lens material. It is crucial to maintain open communication with your eye care provider to monitor your symptoms and explore appropriate management strategies. Your experience is not uncommon, and understanding the underlying mechanisms can help alleviate concerns and guide you toward the best course of action for your eye health.

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