Cataract Surgery with Retinal Tear and Silicone Oil

Question: I have had 4 surgeries, on my right since January of 2010 to try and fix a retinal tear. Currently I have silicone oil in the eye to keep the retina in place. This was put in for the 2nd time in September of 2010. I also have a significant Cataract in that eye. I wanted to know if Cataract Surgery can be done with the oil still in place.

Answer: The simple answer is yes, Cataract Surgery can be performed in an eye that has silicone oil in place to support a retinal tear. BUT, it is certainly a high risk and complex Cataract Surgery procedure for a number of reasons. It is not uncommon for patients who have silicone oil for a second time to have it for a very long time and even permanently. The timing of going back and having another intraocular procedure such as Cataract Surgery is usually set by the Retina Surgeon in instances such as this due to the risk. That decision is made based on the visual significance of the Cataract to BOTH the patient and the Retina Surgeon who needs to be able to visualize the retina comfortably. The issues with Cataract Surgery in eyes with silicone begin with getting an precise measurement for the intraocular lens (IOL) power-fortunately using a technique called "partial coherence interferometry" to measure eyes containing silicone oil in the vitreous cavity has made this relatively easy today. There is the risk that the oil can migrate and damage the trabecular meshwork causing glaucoma or into the anterior chamber of the eye damaging the corneal endothelium. All of these complications raise the risk and need to be considered. That said, it is worth having that discussion with your Retina Surgeon. It is highly likely that he or she will have a top Cataract Surgeon they work in concert with in terms of surgical planning specific to your situation.

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