Lens replacement surgery — including cataract surgery with intraocular lens (IOL) implantation and refractive lens exchange (RLE) for high myopia or presbyopia — is one of the safest and most commonly performed eye operations. But when the wrong lens power is calculated and implanted, when pre-operative assessment is inadequate, or when the patient is not properly counselled about the limitations and risks, the result can be permanent refractive error — leaving a patient who was expecting excellent post-operative vision with significant long-term glasses dependence or monocular visual imbalance. This guide covers when lens replacement surgery gives rise to a negligence claim.
Common lens replacement negligence scenarios
- Incorrect IOL power calculation causing significant residual refractive error
- Failure to identify corneal pathology (keratoconus, corneal scarring) contraindicting certain IOL types
- Failure to counsel patients about the limitations of multifocal IOLs — particularly dysphotopsia, halos, and glare
- Failure to obtain Montgomery-compliant informed consent for the risks
- Surgical complications — posterior capsule rupture, dropped nucleus — from technique below the required standard
- Failure to treat post-operative complications (endophthalmitis, cystoid macular oedema) in time
Frequently asked questions
Can I claim if I have very poor vision after lens replacement that was not discussed as a risk?
Possibly — under the Montgomery standard, all material risks of lens replacement surgery, including the possibility of significant residual refractive error, must be disclosed. Where a patient was not warned of a risk that a reasonable person would have wanted to know, and that risk materialised, a consent claim may be available.