What Are the Disadvantages of Cataract Surgery

Cataract surgery is one of the safest, most successful procedures in medicine — the vast majority of people who have it end up seeing better than they have in years. That success rate is real, and it’s why surgeons recommend it so readily. But “very safe” isn’t the same as “risk-free,” and if you’re weighing whether to go ahead, you deserve the honest fuller picture, not just the reassuring headline.

TL;DR: Cataract surgery has a high success rate — above 95 percent for improved vision — but it is not risk-free. Most people experience mild, temporary side effects like dry eye or glare while healing, and serious complications such as infection or retinal detachment are uncommon but possible.

This article walks through the actual downsides: the common, mild, temporary ones almost everyone experiences to some degree, and the rarer, more serious complications worth knowing about before you sign a consent form.

How Common Are Complications, Really?

Serious complications from cataract surgery are uncommon — most studies, including data reported by the Canadian Ophthalmological Society, put the rate of significant complications well under 5%, and the overall success rate for improved vision sits above 95%. That’s an excellent track record for any surgical procedure.

What trips people up is the gap between “rare” and “zero.” A small number of patients will experience something beyond the expected mild, temporary healing symptoms, and it’s worth knowing what that looks like rather than being caught off guard.

What Are the Common, Temporary Side Effects?

These aren’t complications in the serious sense — they’re expected parts of healing for a meaningful share of patients, and they typically resolve within days to a few weeks.

Dry Eye

The surgical incision temporarily disrupts the eye’s normal tear film, and dry, gritty, or scratchy sensations are common in the first few weeks. Artificial tears usually manage this well while the eye settles.

Glare and Halos at Night

Some patients notice glare or halos around headlights and streetlights, especially in the first weeks after surgery. This is usually related to healing and the eye adjusting to the new intraocular lens, and it tends to fade — though certain premium lens types carry a slightly higher long-term risk of this than standard monofocal lenses.

Light Sensitivity

Increased sensitivity to bright light is common during the initial healing period and typically improves within the first week or two.

Blurry Vision During Healing

Vision is often blurry for the first few days as the eye adjusts and any swelling settles. Clear, stable vision usually arrives within a week, though full stabilization can take a few weeks longer.

What Are the Less Common but More Serious Complications?

These are the complications that matter more, though they’re each individually uncommon.

Infection (Endophthalmitis)

A serious but rare infection inside the eye, occurring in roughly 1 in 1,000 surgeries or fewer with modern sterile technique, per the Canadian Ophthalmological Society. It’s the reason post-op instructions around avoiding water, dust, and eye-touching in the first week are taken seriously — see our guide to recovery and activity restrictions for the full list.

Retinal Detachment

A small increased risk of retinal detachment exists in the months following cataract surgery, particularly for people who are highly nearsighted. Sudden flashes of light, a shower of new floaters, or a curtain-like shadow in your vision after surgery should prompt an urgent call to your eye doctor.

Posterior Capsule Opacification (“Secondary Cataract”)

The most common longer-term issue, affecting a meaningful share of patients within months to a few years after surgery. The thin membrane left behind to support the new lens can gradually cloud over, blurring vision again. Unlike the original cataract, this is treated with a quick, painless laser procedure (YAG capsulotomy) rather than another surgery.

Swelling (Cystoid Macular Edema)

Fluid can build up in the central retina after surgery, causing blurred or distorted central vision. It’s usually treatable with eye drops and resolves over weeks to a few months.

Increased Eye Pressure and Glaucoma

Cataract surgery can temporarily or, less commonly, persistently raise pressure inside the eye. For most people this is easily managed, but it’s a real consideration for anyone who already has or is at risk for glaucoma, and your surgeon will typically monitor pressure closely afterward.

Dislocated Lens Implant

Rarely, the artificial lens implanted during surgery can shift out of position, sometimes requiring a follow-up procedure to reposition or replace it. This is uncommon and more likely in eyes with certain underlying structural risk factors.

What Are the Disadvantages of Laser-Assisted Surgery?

Laser-assisted (femtosecond) cataract surgery is often marketed as an upgrade over standard surgery, but the honest picture is more nuanced. The main disadvantages are practical rather than medical: it typically costs significantly more out of pocket, since it’s often not covered the same way as standard surgery, and current research hasn’t consistently shown better long-term visual outcomes compared to standard manual surgery for most patients. It may offer precision advantages in specific cases — your surgeon can tell you whether yours is one of them.

What Are the Trade-offs With Monovision and Lens Choice?

Some patients opt for a monovision approach — correcting one eye for distance and the other for near vision — to reduce dependence on glasses. It works well for many people, but it isn’t without trade-offs: an adjustment period is normal, and some patients find the reduced depth perception or the difference between eyes never fully feels natural. Not everyone is a good candidate, and it’s worth trying with a contact lens trial before committing to it surgically.

Who Is at Higher Risk of Complications?

Certain factors raise the likelihood of complications, though they don’t rule surgery out — they just mean closer monitoring and a more detailed conversation beforehand:

•   Diabetes — particularly if diabetic eye disease is already present, healing can be slower and the risk of swelling somewhat higher.
•   High myopia (severe nearsightedness) — associated with a higher baseline risk of retinal detachment.
•   Previous eye surgery or trauma — can complicate lens positioning or healing.
•   Certain medications — some prostate medications (alpha-blockers) can affect the pupil during surgery; your surgeon needs your full medication list in advance.
•   Existing glaucoma — requires closer pressure monitoring post-surgery.

Why Do Most People Still Choose Surgery Anyway?

Set against this list, it’s worth remembering why the vast majority of people go ahead anyway: cataracts only get worse, never better, and the surgery that treats them has one of the highest success rates in medicine. Most patients report a dramatic, lasting improvement in vision and quality of life — driving at night, reading, recognizing faces, and general independence all tend to improve substantially. For most people, the small, well-understood risks are outweighed by the certainty that an untreated cataract will keep taking away vision.

What Questions Should You Ask Before You Decide?

•   What’s my personal risk level given my health history and eye exam findings?
•   Which lens type is recommended for me, and why?
•   Is laser-assisted surgery worth the added cost in my specific case?
•   What does my recovery timeline realistically look like?
•   What symptoms after surgery should prompt an urgent call rather than waiting for my follow-up?

Ready to Talk to an Optometrist in Vancouver?

The best way to weigh these risks against your own situation isn’t a list on a website — it’s a conversation with someone who has actually examined your eyes. At Dr. Della Chow in Kitsilano, we’ll walk you through what your specific risk factors are, what to expect, and whether surgery makes sense for you right now or is better monitored a while longer.

Book a comprehensive eye exam in Vancouver and we’ll give you a straight answer.

Frequently Asked Questions

What is the biggest risk of cataract surgery?

Serious complications like infection or retinal detachment are the most concerning but are also the rarest, each occurring in well under 1% of cases. The most common longer-term issue is posterior capsule opacification (a “secondary cataract”), which is easily treated with a quick laser procedure.

Is cataract surgery worth the risk?

For the vast majority of patients, yes. Cataracts progressively worsen and cannot improve without surgery, while cataract surgery has a success rate above 95% and very low rates of serious complications. Your optometrist can help you weigh your personal risk factors.

What are the disadvantages of laser cataract surgery specifically?

The main disadvantages are the added out-of-pocket cost and a lack of consistent evidence that it produces better long-term outcomes than standard manual surgery for most patients. It may still be advantageous in select cases.

Can cataract surgery make your vision worse?

It’s uncommon, but possible — usually due to a complication like swelling, infection, or a lens implant issue rather than the surgery itself failing. Most vision changes for the worse after surgery are treatable once identified, which is why follow-up appointments matter.

How long do side effects last after cataract surgery?

Common, mild side effects like dry eye, light sensitivity, and glare typically improve within one to a few weeks. Full visual stabilization can take up to a few months, though most people notice a major improvement within the first week.

This content is for educational purposes only and does not replace a professional eye exam or personalized medical advice. If you notice a sudden change in your vision, contact your optometrist promptly.