Cataracts, childhood - Complications of childhood cataract surgery

Although cataract surgery is very successful, some children may experience complications and need further treatment.

Even if a child's cataracts are successfully removed during surgery, their vision may still be affected by other eye conditions.

For example, lazy eye can occur if there is weaker vision in one eye. This causes the brain to ignore the visual signals coming from the weaker eye, resulting in vision in the affected eye not developing properly. Lazy eye will need further treatment, usually by wearing a patch over the stronger eye, although it may not always be possible to fully correct the problem.

Cloudy vision

If your child has an artificial lens fitted during cataract surgery, the main risk is a condition called posterior capsule opacification (PCO). This is where part of the lens capsule (the 'pocket' that the lens sits inside) thickens and causes cloudy vision. This is not the cataract returning, but is caused by cells growing over the artificial lens.

PCO is common after cataract surgery where an artificial lens is implanted and it usually develops within four to 12 months of having the operation.

If your child develops PCO, they may need another operation to correct it. This will be done with laser eye surgery (when energy beams are used to cut through part of the eye). During laser eye surgery, the cloudy part of the lens capsule will be removed, with enough left to continue holding the artificial lens in place.

This procedure should only take around 15 minutes, and vision should be improved immediately or within a few days. As no surgical incisions or stitches are necessary, your child can usually return to their normal activities straight away. 

Other complications

Other complications that can occur after an operation to remove childhood cataracts include:

• glaucoma – where vision is affected by increased pressure inside the eye
• squint – where the eyes look in different directions
• abnormalities affecting the pupil, such as it becoming a more oval shape – this is common and doesn't usually affect vision
• retinal detachment – where vision is affected by the retina (layer of nerve cells inside the back of the eye) becoming separated from the inner wall of the eye
• cystoid macular oedema – where fluid builds up between layers of the retina, sometimes affecting vision
• infection – such as endophthalmitis (a rare bacterial infection)

In many cases, medication or further surgery will be required to treat these problems if they develop.

When to seek medical advice

If your child has any signs of pain, bleeding, a lot of stickiness or redness in or around the eye after surgery, contact the hospital where the operation was carried out immediately.