Is There a Downside to Cataract Surgery?

Cataract surgery is one of the safest and most effective procedures in medicine, restoring clearer vision for millions of patients each year. Most people recover quickly and enjoy dramatically improved sight. Still, every surgery carries risks. Understanding the potential downsides, how often they occur, and what symptoms truly need urgent attention can help you feel confident and prepared as you plan your procedure.

This guide explains the most common issues patients experience, how SightMD works to reduce risk, and the steps to take if something feels off during recovery.

Quick Facts About Cataract Surgery

Cataract surgery has a strong track record of success, with the vast majority of patients noting clearer, brighter, and more comfortable vision after their procedure. Studies consistently show high satisfaction and low complication rates. A well-known delayed issue is posterior capsule opacification, sometimes called a secondary cataract, which can cause glare or blurred vision months or years after surgery. It is easily treated with a brief in-office laser procedure.

While serious complications such as infection or retinal detachment are rare, they do require rapid evaluation. Patients should always contact their surgeon promptly if they notice sudden pain, vision loss, or flashes and floaters.

Common Downsides and Complications

Even with excellent surgical outcomes, the healing process and the eye’s natural response to surgery can create temporary or occasional issues. Most are treatable or self-limited, but it helps to know what to expect.

Temporary Dryness, Glare, or Halos

After surgery, the surface of the eye may feel dry or scratchy as the tear film stabilizes. Glare, halos, or increased sensitivity to bright lights often occur during the early healing period. These sensations typically improve within days to weeks. Using preservative-free artificial tears, wearing sunglasses outside, and continuing postoperative drops exactly as directed are usually enough to help the eye heal. If glare or halos persist longer than expected, let your doctor know. Sometimes a mild glasses prescription, adjustments to the ocular surface, or a minor laser enhancement can help refine the final vision.

Refractive Surprise

Even with today’s advanced measurements, some patients do not land precisely on their intended prescription. This is more likely in eyes that are extremely nearsighted or farsighted, in patients who previously had LASIK or PRK, or in those with dense or complex cataracts. When this happens, options may include glasses, contact lenses, a small laser adjustment in appropriate cases, or rarely an intraocular lens replacement. When planning surgery, your surgeon will explain your personal risk factors and discuss the best strategies to meet your visual goals.

Posterior Capsule Opacification

Posterior capsule opacification, or PCO, occurs when the thin membrane behind the implanted lens becomes cloudy. It can develop weeks, months, or years after surgery and is considered part of the normal healing process rather than a return of the cataract itself. Symptoms include blurry vision, glare, halos, or reduced contrast. Treatment involves a quick, painless YAG laser capsulotomy performed in the office. Most patients experience rapid improvement in vision afterward.

Cystoid Macular Edema

Cystoid macular edema, or CME, is inflammation in the retina that can cause blurry or wavy central vision several weeks after surgery. It often appears after an initial period of clear sight. Most cases respond well to anti-inflammatory prescription drops, though some patients require additional therapies. Regular follow-up helps ensure CME is detected early and treated effectively.

Infection Inside the Eye

Endophthalmitis, an infection inside the eye, is extremely rare but serious. Symptoms typically occur within the first one to two weeks. Warning signs include severe pain, rapidly worsening redness, sudden vision loss, thick discharge, or sensitivity to light. Immediate evaluation is critical, and patients should contact SightMD the same day if they notice any of these symptoms.

Retinal Tear or Detachment

Retinal complications after cataract surgery are uncommon overall but occur more frequently in individuals with high myopia, lattice degeneration, or prior retinal problems. Symptoms include flashes of light, many new floaters, or a shadow or curtain in the peripheral vision. These signs require same-day evaluation to protect vision.

IOL-Related Issues

In rare cases, the intraocular lens can shift, tilt, or cause bothersome reflections known as dysphotopsias. Many mild reflections fade naturally as the brain adapts. Persistent symptoms may be managed with glasses, surface treatments, or lens repositioning when appropriate.

How Often Do These Issues Occur?

Complication rates vary based on patient factors, lens selection, and surgical complexity. Below is a simple, plain-language overview to help patients understand relative frequency.

Common: Dry eye symptoms, glare and halos during early healing, and posterior capsule opacification over time.
Uncommon: Refractive surprises requiring glasses or enhancement, cystoid macular edema.
Rare: Infection, retinal detachment, and significant IOL dislocation.

Your surgeon will tailor the conversation to your specific eye health and explain which risks apply to you.

Who Is at Higher Risk?

Certain medical or ocular conditions increase the likelihood of complications. Patients with high myopia, diabetes, previous retinal disease, prior eye surgery, uveitis, or very dense cataracts may require additional planning and follow-up. Medications such as alpha-blockers can also affect the iris during surgery. Sharing a complete health and medication history helps ensure the safest possible procedure.

How SightMD Lowers Surgical Risk

SightMD uses a carefully structured approach before, during, and after surgery to support exceptional outcomes. Comprehensive pre-operative testing provides precise measurements of the cornea, eye length, and lens positioning. This information guides accurate lens selection, whether a monofocal, toric, or presbyopia-reducing lens is best for your goals.

Our surgeons use advanced surgical technology, including modern phacoemulsification systems and, when appropriate, femtosecond laser assistance for added precision. Every patient receives evidence-based antibiotic and anti-inflammatory protocols to help prevent infection and control inflammation. After surgery, clear instructions and close follow-up ensure the eye heals well. If an urgent symptom arises, same-day evaluation is available at SightMD locations.

When to Call Your Doctor

Certain symptoms after cataract surgery require immediate attention. Patients should contact SightMD right away if they experience severe or increasing pain, a sudden drop in vision, many new floaters, flashes of light, a dark curtain or shadow, worsening redness, or thick discharge. When in doubt, it is always better to call.

Benefits Still Outweigh the Risks

For most patients, the advantages of cataract surgery far exceed the potential downsides. After recovery, colors often appear brighter, contrast improves, and everyday tasks like reading signs or driving at night become easier. Patients with coexisting conditions such as macular degeneration or glaucoma may have more limited improvements, but surgery can still provide meaningful clarity and safety benefits.

Understanding Your Vision Goals

Clear visual goals help guide the selection of the best intraocular lens. A distance-focused monofocal lens offers excellent clarity for far vision, paired with reading glasses for close tasks. Toric lenses can reduce astigmatism and may decrease reliance on glasses. Patients seeking a broader range of vision may consider presbyopia-reducing lenses that improve distance, intermediate, and some near tasks. These lenses can increase the chance of glare or halos for a small percentage of patients, so a thoughtful discussion helps determine the right choice. Some individuals also consider monovision or blended vision, where one eye focuses on distance and the other on near work.

What Recovery Looks Like

Most patients return to normal light activity the day after surgery. Eye drops must be used on schedule for proper healing, and it is normal for the eye to feel gritty or slightly dry for a short period. Makeup, swimming, exercise, and dusty environments should be avoided until your doctor gives clearance. Any concerning symptoms should be reported promptly.

Frequency Overview: Common, Uncommon, and Rare

1. Common or expected healing experiences:
Dryness, mild irritation, glare, halos, temporary blurriness, and posterior capsule opacification over time.

2. Uncommon or rare complications:
Refractive surprises, cystoid macular edema, infection, retinal tear or detachment, and significant IOL movement.

The Bottom Line

Cataract surgery is highly successful and can significantly improve quality of life. Downsides do exist, but most are temporary, treatable, or considered part of the natural healing process. A personalized surgical plan, precise measurements, and quick access to care all support a smooth and safe recovery. If you are considering cataract surgery, schedule a consultation at SightMD. Your surgeon will review your eye health, discuss your vision goals, and help you make an informed decision.