Cataract surgery is one of the most commonly performed and most successful surgeries worldwide. According to the National Institutes of Health (NIH), almost 95% of patients experience better vision after the procedure when no other eye conditions are present.

Despite this remarkable success, cataract surgery—like any surgical procedure—still carries risks, side effects, and long-term considerations. These disadvantages do not mean cataract surgery is unsafe; instead, they help patients set realistic expectations, prepare fully, and make informed decisions.

In this comprehensive blog, we explore short-term, long-term, and rare disadvantages of cataract surgery, backed by clinical research and government-verified data.

What Are the Main Disadvantages of Cataract Surgery?

While the benefits outweigh the risks for most patients, the disadvantages include:

• Infection or inflammation
  
• Posterior capsule opacification (PCO)
  
• Glare, halos, and visual disturbances
  
• Retinal detachment
  
• Swelling (CME) or corneal edema
  
• Elevated eye pressure
  
• Dry eyes
  
• Anesthesia side effects
  
• Lens-related complications
  
• Possible continued dependence on glasses
  
• Increased risks in certain patients (diabetes, age, high myopia)
  

Each of these is explained in detail below. This comprehensive guide covers every possible disadvantage, from common and temporary post-operative side effects to long-term concerns and rare but serious complications.

What are the disadvantages of cataract surgery

1. Infection Risk (Endophthalmitis)

Infections after cataract surgery are rare but serious.

How common is infection after cataract surgery?

A major study from the British Journal of Ophthalmology reports that endophthalmitis occurs in 0.06%–0.20% of cases

This means:

• Infections occur in between 6 in 10,000 and 2 in 1,000 surgeries.
• The risk is extremely low, but the consequences can be severe.

Symptoms include:

• Severe eye pain
  
• Redness
  
• Blurry or worsening vision
  
• Light sensitivity

Why is this a major disadvantage?

Because untreated infection can cause permanent vision loss, immediate treatment is necessary.

Fortunately, modern sterilization, antibiotic injections, and advanced surgical protocols have kept infection rates very low.

2. Inflammation and Swelling (CME and Corneal Edema)

After surgery, it’s normal to have mild inflammation. But in some patients, swelling becomes significant.

How common is swelling?

Cystoid macular edema (CME)—a swelling in the retina—occurs in 1%–2% of patients with modern surgery techniques.(NIH —https://www.ncbi.nlm.nih.gov/books/NBK559253/ )

Corneal swelling (edema) may last a few days or weeks and is more common in people with:

• Fuchs’ dystrophy
  
• Long-standing cataracts
  
• Diabetes

Why is this a disadvantage?

Because swelling can delay visual recovery and may temporarily blur vision. Most cases are treated successfully with anti-inflammatory drops, but severe cases can require longer follow-up care.

3. Posterior Capsule Opacification (PCO)

Also known as a “secondary cataract,” PCO is the most common long-term disadvantage of cataract surgery.

How common is PCO?

Studies show that 20%–50% of patients develop PCO within 2–5 years after surgery ( EyeWiki ). Another review found 2.4%–12.6% of patients require laser YAG capsulotomy within 3 years. (Reference: https://clinicaloptometry.scholasticahq.com/article/82056 )

Why is this a disadvantage?

Because:

• Vision becomes cloudy again.
  
• Treatment requires a YAG laser procedure.
  
• Some patients may notice floaters after laser treatment.

However, YAG treatment is quick, painless, and usually resolves the issue permanently.

4. Visual Disturbances: Glare, Halos, and Starbursts

Some patients experience unusual visual patterns after cataract surgery, especially at night.

Common complaints:

• Halos around lights
  
• Glare while night driving
  
• Decreased contrast sensitivity

These symptoms are more common with:

• Multifocal intraocular lenses (IOLs)
  
• Patients with dry eye
  
• Large pupils in dim light

Why do these happen?

Because new artificial lenses refract light differently than natural lenses. For most patients, the brain adapts within weeks or months. For a small percentage, symptoms may persist longer.

5. Retinal Detachment

This is one of the rare but most serious risks.

Who is at higher risk?

Patients with:

• High myopia (minus-number spectacles)
  
• Family history of retinal detachment
  
• Trauma
  
• Previous retinal conditions

Even though rare, retinal detachment requires immediate treatment.

Warning signs:

• Sudden flashes of light
  
• New floaters
  
• Curtain-like shadow over vision

6. Elevated Eye Pressure (Risk of Glaucoma)

During or after cataract surgery, intraocular pressure (IOP) may rise.

Who is most affected?

• Patients with glaucoma
  
• Patients with thick cataracts
  
• Those with a family history of glaucoma

Uncontrolled eye pressure can damage the optic nerve, making monitoring essential.

7. Dry Eyes and Tear Film Instability

Many patients report dry eyes after surgery.

Why does it happen?

• Temporary nerve disruption on the cornea
  
• Pre-existing meibomian gland dysfunction
  
• Exposure to bright operating lights

Long-term dry eye risk

Although most cases improve in weeks, some patients—especially older adults—may require long-term lubricating drops.

8. Anesthesia-Related Side Effects

Cataract surgery is performed under local, topical, or regional anesthesia, not general anesthesia.

Possible side effects:

• Dizziness
  
• Nausea
  
• Light-headedness
  
• Temporary eyelid droop

These are usually mild and short-lived.

9. Lens-Related Complications (IOL Dislocation or Power Errors)

Although rare, problems with the artificial lens may occur.

Potential issues:

• The IOL shifts out of position (dislocation)
  
• Incorrect lens power leads to refractive error
  
• Lens edge glare or reflections

Why is this a disadvantage?

Because correcting these issues may require:

• Additional glasses
  
• A laser procedure
  
• IOL repositioning surgery (rare)

10. Continued Dependence on Glasses After Surgery

Many patients assume cataract surgery guarantees perfect vision—but this is a misconception.

You may still need glasses for:

• Reading (if monofocal IOL is used)
  
• Intermediate tasks like computer work
  
• Night driving
  
• Astigmatism correction (if toric IOL not chosen)

Premium lenses reduce dependence on glasses, but no technology guarantees complete independence.

11. Long-Term Disadvantages

Beyond immediate recovery, there are long-term considerations:

• Increased dry eye tendencies

• Progressive retinal diseases may still develop

• Need for occasional vision check-ups

• PCO recurrence risk if laser treatment is delayed

12. Who Is at Higher Risk of Complications?

Certain medical and ocular conditions elevate risks.

Diabetes

Diabetic patients are significantly more prone to:

• Swelling (CME)
  
• Retinal complications
  
• Slower healing

Glaucoma

High intraocular pressure must be monitored closely.

High Myopia

Patients with high minus power have:

• Increased retinal detachment risk
  
• Longer eye length affecting recovery

Age Above 70–80

Older adults:

• Heal slower
  
• Have more inflammation
  
• May have other eye diseases

Surgeon Experience

Studies show complication rates drop significantly with more experienced surgeons.

13. Common Misconceptions About Cataract Surgery

Myth 1: Cataract surgery guarantees 20/20 vision.

Fact: Vision depends on:

• Retinal health
  
• Lens selection
  
• Existing eye conditions

Myth 2: Surgery is painful.

Fact: Most people feel pressure, not pain, due to local anesthesia.

Myth 3: You won’t need glasses afterward.

Fact: Many still use reading or driving glasses.

Myth 4: Recovery takes months.

Fact: Most resume normal activities in 2–3 days, with full healing in several weeks.

Conclusion: Should You Be Worried About the Disadvantages?

Cataract surgery remains one of the safest and most effective surgeries in medicine, with complication rates generally below 2%.(Reference: https://www.ncbi.nlm.nih.gov/books/NBK559253/)

Most disadvantages:

• Are rare
  
• Are treatable
  
• Can be minimized with follow-up care and experienced surgeons

The key to successful outcomes is:

• Understanding potential risks
  
• Choosing the right IOL
  
• Following post-surgery instructions
  
• Attending your follow-up visits

When performed at the right time and by a skilled ophthalmologist, cataract surgery significantly improves quality of life with very low risk.

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FAQ: Disadvantages & Risks of Cataract Surgery