Cataract Surgery and Scleroderma

Question: I am 51 yrs old and have been on prednisone therapy for the past 3 years, due to Scleroderma and dermatamyositis. About 1 ½ yrs ago I started to notice a problem and was diagnosed with cataracts in both eyes. I was not really happy with the cataract surgeon that I saw at a large eye center. Also, had LASIK about 9 years ago. And, would the Scleroderma or dermatamyositis cause any issues with cataract surgery?


Answer: Cataract formation secondary to prolonged use of steroids is a known and expected side effect that increases with dosage. Generally, low doses of steroids daily, say 10 mg or less per day, may only increase the risk of Cataracts by 10% or so, the risk may increase to 30% if you take 10-15 mg daily and even to 80% if you need to take more than 15 mg per day. However, there really shouldn't be any unusual complications with Cataract Surgery secondary to the autoimmune issues you describe, although you may experience some longer than usual dry eye symptoms. Now, the fact that you have had LASIK does mean that there is a need to take very careful measurements for your intraocular lens implant (IOL) as previous LASIK surgery can make these measurements more complex. Your situation would be best handled by a top Cataract Surgeon who is also a LASIK Surgeon. In addition, if at all possible it would be quite helpful if you could provide your preoperative examination results, measurements and notes to the cataract and Refractive Surgeon you ultimately choose.


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