Wednesday, November 30, 2011

Removing a Wrong Lens Implant

Question: If the wrong lens implant was inserted during cataract surgery can it be removed after a year?

Answer: Removing or explanting or exchanging a Lens Implant a year after Cataract Surgery is possible but depends on a number of factors and often requires an extraordinary effort and technique by the Cataract Surgeon. It is odd that a Lens Implant would be deemed "wrong" after such a long period of time but it is possible. Factors that could complicate a lens implant removal or exchange after a year might include the placement of the lens itself and whether it was fibrosed in place, whether a YAG Laser Capsulotomy had been performed as well as whether the vitreous had been violated in any manner and the overall health of the cornea. If any of these conditions exists it might be worth seeking a consultation with a Corneal Specialist who is also a top Cataract Surgeon.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, November 29, 2011

Pressure on Eye after Cataract Surgery

Question: What damage might be caused by putting pressure on eyeball two days after cataract surgery? A misplaced lens or retinal tear have been ruled out by examination. But the image is blurred especially at a distance and there are ghost images and even double vision in that eye.


Answer: While it is simply impossible to tell without a thorough examination, there could be an almost limitless number of remote possibilities that could occur. If there has been a "pressure" related event that causes any type of inflammation with or without associated swelling of the Macula, it could cause Cystoid Macular Edema which occurs in a small number of patients after Cataract Surgery. Likewise, if there is residual induced corneal edema this too could cause these symptoms. Further, and very unlikely there could have been damage to the posterior capsule, intentionally left in place to support the Lens Implant, causing it to prematurely fibrose leading to symptoms like these. However, these are purely conjecture as there are many possibilities that can only be determined with a careful examination by your Cataract Surgeon.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Near-Intermediate Vision Correction & Cataract Surgery

Question: I'm now contemplating cataract surgery and have decided that I want mini-Monovision, rather than multifocal lens implants. I would also not like to have a big correction disparity between each eye - e.g., maximum 1.25 D. My goal is to attain very good vision for the following kinds of "near-intermediate" activities: Sitting at a table playing cards, shaving, seeing the dashboard of my car, searching through drawers, looking at my cell phone, reading a menu, walking down the aisle of a market, and reading the labels on cans (at least the larger type). As a trade-off for very good "near-intermediate" vision, I would be willing to sacrifice some sharpness in distance vision - perhaps 20/40? Here's my thinking: It seems that if I was corrected for very good "near-intermediate," I could probably go without glasses about 90% of the time --needing them only for really sharp distance (e.g., driving, tennis), and readers for the fine print. My questions are: Is it possible to get the type of good near-intermediate vision I'm seeking, and still be 20/40 for distance? If so, what would your target correction be (with a maximum of 1.25 D difference between the eyes)?


Answer: First, you are asking the right questions to help you identify the most acceptable choices and compromises for your vision correction after Cataract Surgery. Monovision Cataract Surgery requires careful measurement of the near and intermediate working distances your desire clarity for as well as identifying the specific tasks. While you have identified the tasks, the actual working distances of those tasks can vary greatly by your personal physical stature and size. For example if you are 5'4'' tall with medium length arms you will require different working distances than someone 6'2" tall with long arms. Next, the achievement of the results you are requesting could also depend on several other factors including but not limited to the type of Lens Implant to be used and whether it is a spherical or aspheric design, your pupil size as this contributes to your ultimate depth of focus, the amount and type of spherical aberration in your eye as well as your overall tolerance and threshold to "defocus." Now, in order to consider these factors, if you have not already done so, it would be wise to be sure that you had a complete refractive Monovision evaluation as part of your Cataract consultation at which time detailed measurements could be taken and analyzed AND it might be possible to provide you with trial contacts to demonstrate the defocus and working distances that could be achieved. This kind of trial will really depend on the degree of cataract formation you presently have. In general, the scenario you describe is achievable but does require careful measurement and testing in order to select a proper target correction-AND may require specialized testing for the actual Lens Implant selection. To obtain this level of testing and precision we would suggest you choose an eye surgeon who is both a Cataract Surgeon and a Refractive Surgeon and thus fully equipped to deal with the precision of the measurements and the testing required to achieve your personal goals here.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Eyelea for Macular Degeneration Help

The FDA has offered additional help for patients with Wet Age Related Macular Degeneration (AMD) by approving a first-in-class drug called Eyelea (aflibercept). Eyelea is called a VEGF Trap-Eye that is a protein drug that soaks up the vascular endothelial growth factor molecules that promote the unhealthy growth of new blood vessels under the Retina. According to the FDA-approved labeling for aflibercept, the drug is indicated for the treatment of patients with neovascular Age-Related Macular Degeneration (Wet AMD) and may be given by intravitreal injection as frequently as 2 mg every four weeks, but additional efficacy was not demonstrated with this schedule compared with the eight-week interval. As with other drugs that are VEGF inhibitors, there is a potential risk of arterial thromboembolic events, defined as nonfatal stroke, nonfatal myocardial infarction, or vascular death (including deaths of unknown cause) with the incidence of such events in the aflibercept trials occurring in 1.8% of patients.

Glaucoma & Risk of Erectile Dysfunction (ED)

Researchers reporting in the October 2011 publication Ophthalmology reported on a novel association between Erectile Dysfunction (ED) and Glaucoma in patients who were previously diagnosed with Open Angle Glaucoma (OAG). Open Angle Glaucoma (OAG) is known to be associated with certain systemic metabolic and cardiovascular disorders, and these systemic and metabolic disorders share common risk factors with Erectile Dysfunction (ED). However, few studies have investigated the association of ED with OAG. A nationwide study in Taiwan aimed to estimate the association of ED with prior OAG by using and found that patients with ED were more likely to have prior OAG than controls, indicating a novel association but requiring additional study to fully understand the clinical significance of the findings.

Monday, November 28, 2011

Cataract Surgery, Lens Implant & Eyeglass Lens Changes

Question: After cataract surgery would you have to have a change of eyeglass lens or lens implant at some time latter as you get older?


Answer: Once you have Cataract Surgery and a Lens Implant, generally, unless you develop some other type of eye disease that impacts the refractive error of your eyes-such as a corneal disease or diabetic macular edema-it is not likely that your optical prescription will change too much. In any event the nature of the optical changes that might occur rarely necessitate a change of Lens Implant but could require a small change in an eyeglass lens prescription over time as the eye changes corneal curvature or other parameter.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, November 22, 2011

Complications from Cataract Surgery

Question: I seem to have a lot of complications from my cataract surgery. I had cataract surgery on my right on July 1, 2011 with a lens implant to correct my far and near vision. I have been back to the eye doctor 8 times complaining that my vision has not improved and actually it has worsened. He used the laser to remove the part of the capsule and that has not helped. Now I am seeing floaters and funny shapes in my vision. I went to see the doctor this past Friday and he says he noticed that there is some swelling of the Retina and he has given me some new drops and says come back in a month. Why is it that after spending $7000 I can't see? Should I be looking for another doctor?
Answer: While Cataract Surgery and Lens Implantation are among the most frequent and most successful types of eye surgery one can have, there is always the risk of side effects and complications that can result from the surgery itself or simply just from the condition and health of the eye-unrelated to the surgery. Although it is impossible to know exactly what is going on with your eyes and vision you are describing some things that we know can sometimes occur. First, you describe the need to be treated with a laser to "remove" part of the lens capsule. In as many as 30% of the people having routine Cataract Surgery, the posterior lens capsule-normally left intact to support the Lens Implant-does become cloudy or opacified. This is treated with a procedure called a YAG Laser Capsulotomy in which an opening in placed in the capsule with a laser in order to allow light to readily pass through to the back of the eye. While not every patient requires this, it is not uncommon and represents one of the most common complications of Cataract Surgery. However, the YAG Laser treatment is quite effective in restoring vision in almost every instance of posterior capsular opacification. The fact that you are experiencing floaters may or may not be related to the Cataract Surgery. You are possibly describing a vitreous detachment that may have occurred spontaneously or in conjunction with the Cataract removal.

IF you have a vitreous detachment that is causing the floaters they will self limit over time and will likely no longer disturb your vision. But it takes time and your Cataract Surgeon will want to be sure that there are no associated tears in the Retina contributing to the floaters. Another complication that are possibly describing is the presence of Cystoid Macular Edema which is a painless swelling of the Retina that can cause blurred vision and distortion. it is thought to be due to post operative inflammation and may occur in about 1% of the patients having Cataract Surgery. While the pre and post operative drops that are normally prescribed are usually sufficient to manage the inflammation, sometimes they require an additional or alternative more powerful anti-inflammatory eye drop to reduce the inflammation and the swelling. Although it is difficult for you to be the recipient of what seems like so many complications, they are all familiar and known complications of Cataract Surgery-albeit unusual. However, they are also pretty much manageable over time with careful observation, testing and treatment. That said, it is never inappropriate to get a second opinion in order to confirm the diagnosis and treatment as well as the prognosis. If it would make you more comfortable you should either find the best Cataract Surgeon in your area or even find a Retinal Specialist who can give you an opinion regarding your individual situation.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery and Brain Bleeding

Question: Can Cataract Surgery cause a brain hemorrhage or brain bleeding?
Answer: Cataract Surgery and Lens Implantation is actually not known to be associated with a complication of brain hemorrhage or bleeding. While not inconceivable as there are certainly complications that do rarely occur, it would be a very remote possibility that such an event could occur as a result of a Cataract removal, rather than as a result of other health conditions present in someone having Cataract Surgery.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cost of Multifocal Lens Implants

Question: What is the average out of pocket cost for the Multifocal Lens Implants? Also, is there any indication that Medicare will approve this type for payment?
Answer: There are some points of clarification that should be made regarding the cost and fees associated with Multifocal Lens Implants for Cataract Surgery. First, the correction of near vision and presbyopia-the age related near vision focusing problem is NOT a covered service under Medicare. Given that the Obama administration and Congress need to cut trillions of dollars in spending-and physician fees and services are in the cross hairs of the target-it is unlikely that ANY current non covered services will become covered services in the future and in fact it is probable that more and more of the costs of Cataract Surgery and Lens Implants will be both directly and indirectly increased for patients. Second, when considering the fees and costs of Multifocal Lens Implants, it is important to understand that the actual cost of the Lens Implant is actually only one component of the fee charged to patients. The fees for a Multifocal Lens Implant typically reflect the actual cost of the implant plus additional fees for other non covered services associated with the measurement and calculation of the more complex Lens Implant including but not limited to Corneal Topography to measure the shape of the Cornea, Corneal Pachymetry to measure the thickness of the Cornea, Ocular Coherence Tomography (OCT) to confirm the integrity of the Macula and the Retina, perhaps aberrometry, additional biometry measurements to confirm the lens power calculations which may also include as necessary the cost of astigmatism correction such as Limbal Relaxing Incisions (LRI) or a Laser Eye Surgery procedure such as LASIK. This additional testing and its interpretation as well as the "as needed" necessity for the additional procedure is most often "bundled" into the fee charged to patients. In general to cost of these services plus the Multifocal Lens Implant itself can range in cost from $2000-$3500 per eye depending on location and the scope of what exactly is included in the fee.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Thursday, November 17, 2011

Cataract Surgery Measurements & Contacts

Question: How long should you go without hard contacts before a true measurement for cataract surgery can be taken?


Answer: There is no hard and fast rule for the discontinuation of contact lens wear in order to take measurements for Cataract Surgery and Lens Implants (IOL) as it can vary greatly depending on the cumulative length of time the contact lenses have been worn for, the health and shape of the cornea and the individual patient ocular rigidity. However, as a practical matter during your initial examination and consultation the shape, topography and thickness of your cornea can be measured giving some indication of the degree of change induced by your contact lenses-if any! It may be necessary to have you discontinue them for some time and recheck the stability and reproducibility of the measurements after a few weeks. Once there are two consistent sets of measurements the final calculations can be performed. Sometimes this can take as few as two weeks and sometimes-if there is considerable distortion in the shape of the cornea-it can take a couple of months. Be patient and follow your Cataract Surgeon's instructions carefully.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, November 14, 2011

Sedation & Anesthesia for Cataract Surgery

Question: I have a question regarding anesthesia and sedation for cataract surgery. I am scheduled to see an ophthalmologist for cataract surgery. My daughter-in-law works in the office and when I asked her what they use for sedation she said they give you "happy pills". I have an cervical essential head tremor and cervical dystonia and I am claustrophobic, so I hope they will use a deeper sedation so they will not have to deal with my head shaking. Can you help answer this question for me? Thank you for your help.

Answer: While the most common types of anesthesia and sedation for Cataract Surgery might be eye drops and a tablet to help you relax, top Cataract Surgeons evaluate the needs of each and every patients as individuals in order to determine the best approach to sedation and anesthesia. That is to say that they have a wide choice of how to make patients most comfortable and provide a quick, safe Cataract removal for patients based on their individual situation. Trust your Cataract Surgeon to discuss your needs and make the appropriate choices with and for you.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Astigmatism, Glare & Halo after Cataract Surgery

Question: After cataract surgery that was to correct both near and far vision I am having trouble with far vision and have terrible glare and halos when driving at night. I have an astigmatism in that eye and my distance vision is not good. My near vision has improved. It has been suggested that I have a laser treatment in that eye to get rid of the astigmatism. The after affects of laser seem to say I would still have halos at night and perhaps blurry vision as I have now. Would this be a treatment that I should consider or are the possible side affects not worth it.


Answer: Unfortunately your question leaves out a number of key details that would allow us to offer a direct response so we will try to respond in general terms. First, if you had preexisting astigmatism before your Cataract removal it certainly would need to be corrected during or after your Cataract Surgery in order for you to get the best possible vision. Astigmatism for people with Cataracts can be corrected by using an astigmatism correcting toric lens implant, by using a secondary procedure called Limbal Relaxing Incisions (LRI), by having a Corneal Laser Eye Surgery procedure such as LASIK or by wearing eyeglasses with the correction for the astigmatism. You have to correct the astigmatism by one of these methods if you want to get the best vision correction after Cataract Surgery. Although you do state that as part of your Cataract Surgery your vision was to be corrected for both far and near, you do not state whether that was done with Monovision Cataract Surgery or a Near Vision Presbyopic Correcting Multifocal Lens Implant or an Accommodating Lens Implant.

Depending on the type of Multifocal Lens Implant, there may be predisposition to cause glare and halo side effects-in many cases these complaints resolve as patients adapt to the vision with the Lens Implant. In some cases patients do not adapt to the glare and halo and the Lens Implant needs to be removed-but this is only in a very small percentage of instances. Nonetheless, you do NOT get good vision with Near Vision Presbyopic Correcting Multifocal Lens Implant or Accommodating Lens Implants if there is uncorrected astigmatism.

Further, the glare and halo could be caused by a number of other factors that would require careful examination. So, you have to have the astigmatism corrected AND you have to discuss the annoyance of the glare and halo with your Cataract Surgeon as this may simply be due to adaptation and self limiting or may have another cause that needs to be addressed. If after discussing the situation in depth with your Cataract Surgeon you still do not feel comfortable, it is completely appropriate to get a second opinion prior to electing another surgical procedure. If you seek a second opinion you might want to make sure that it is with someone who is BOTH a Cataract and Refractive Surgeon and thus has the breadth of experience in both surgery areas of Surgery and LASIK Surgery.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Heavy Lifting after Cataract Surgery

Question: If a person who had cataract surgery was told not to lift heavy objects but did, not thinking that it was that heavy, what would happen to their eye to let them know that they damaged their eye?


Answer: Most Cataract Surgeons tell patients to avoid heavy lifting or really excessive exertion of any type in order to prevent a short burst of pressure from building up in the eye or suddenly shifting or changing the position of the eye's delicate tissues during the healing process. While it would be unusual, depending on the time period of the exertion after the surgery, there is a range of adverse effects that can result including some leakage from the incision, traction on the vitreous gel in the back of they eye, dislocation of the Lens Implant and even a remote possibility of a Retinal Detachment. However, all of these are pretty unusual without a great deal of exertion. In most instances there would be some vision compromise that could be noticed. If you are the least bit concerned it would be worthwhile calling your Cataract Surgeon and scheduling a follow up visit just to make sure everything is stable.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Repeating Cataract & Lens Implant Surgery

Question: Can cataract surgery be performed more than once per eye and implant a new intraocular lens?


Answer: Cataract Surgery entails removing the cloudy crystalline lens inside the eye and replacing it with a permanent clear artificial lens. Once the cloudy material is removed it does not regrow and thus does NOT need to be repeated. In some instances the membrane or "lens capsule" that is left in place to support the placement of the Lens Implant can become cloudy and requires an opening be created using a YAG Laser-however it does not require that another Cataract be "removed'. Thus-the answer to your question is that there is no real need to have a repeat of a Cataract operation. There is in some percentage of cases the need for a YAG Laser Capsulotomy. Regarding the need to replace a Lens Implant-modern Intraocular Lens Implants (IOL) last a lifetime and do not "wear out". Unless there is a problem with some other eye problem or condition there is no need to replace a well functioning IOL. Infrequently there may be a need to exchange an IOL in the short period after Cataract Surgery if there is a need to obtain a better optical result although for the most part this is unusual.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Wednesday, November 9, 2011

Age Limit for Cataract Surgery

Question: Is there an age limit for Cataract Surgery? At 92 should my friend have Cataract Surgery. He in lots of pain and takes drugs for pain.


Answer: There is no real age limit for Cataract Surgery. If a Cataract has progressed to a point of interfering with either the quality of one's life or the safety of an individual, and these aspects can be improved by a Cataract operation-it should be strongly considered. There are some practical matters that the Cataract Surgeon would need to carefully consider such as the health of the Retina in particular the Macula as at 92 years old there is a meaningful possibility that the onset of Age Related Macular Degeneration (AMD) has at least commenced and may impact the setting of expectations for the results of the surgery.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery after Macula Detachment

Question: Can cataract surgery improve vision after a macula detachment? I had a retinal detachment in my left eye two years ago that included a macula detachment. The best level of visual acuity achieved since the detachment is about 20/200. I can read with this eye easily, from fairly close up. My retinal surgeon says my retina is stable. Are there cases in which a lens implant resulted in significant vision improvement despite the macula detachment?


Answer: The fact that you had a Macula Detachment and that you report the BEST level of visual acuity since the Retinal Detachment repair is 20/200 suggests that Macula function was impaired by the detachment. However, the fact that you can read is a positive prognostic sign for overall visual improvement if NOT central vision after a Cataract is removed. If the presence of a Cataract is causing a significant reduction of light transmission to the Retina and Macula this could cause a disproportionate loss of contrast sensitivity and associated functioning. HOWEVER, if the BEST corrected visual acuity after the Retinal repair was 20/200 AND THERE WAS NO PREEXISTING CATARACT, the likelihood of a significant improvement beyond that level is small. This does not mean that removing the cataract would not help with overall functioning particularly in reduced contrast situations. This requires thorough and careful evaluation with the best Cataract Surgeon you can find in your area who can offer the full scope of diagnostic and prognostic testing in your individual situation. it would worthwhile to consider this when you are ready.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, November 8, 2011

Cataract & Ovarian Cancer Risk

There may be a relationship whereby women who develop Cataracts are less prone to developing Ovarian Cancer according to researchers. It is widely recognized that the major health benefit of exposure to Ultraviolet (UV) Radiation from the sun is the production of Vitamin D, which is helpful in protection against several human cancers, including Ovarian Carcinoma. On the other hand, Ultraviolet (UV) Radiation from the sun is a recognized risk factor for Cataract development. Researchers reporting in the November 2011 publication Cancer Epidemiology, Biomarkers & Prevention studied 709 women with primary invasive ovarian carcinoma and 1101 controls to examine the association of Ovarian Carcinoma risk with a history of Cataract. Some interesting findings were that older age, a history of Type 2 Diabetes and skin cancer were significant risk factors for developing a Cataract.

Further, a history of Cataract was reported by 14% of cases and 17% of controls and was significantly associated with a reduced Ovarian Carcinoma risk. These findings add indirect evidence to the hypothesis that lifetime Vitamin D exposure may be inversely associated with risk of Ovarian Carcinoma. Additional studies are needed to further investigate the potential behavioral and biological factors that might influence association of cataracts with ovarian cancer.

Tuesday, November 1, 2011

Cataract Surgery with Fuch's Dystrophy

Question: I have Fuch's Endothelial Dystrophy and am having Cataract Surgery with astigmatism surgery on my left eye. What type of things should I be on the lookout for or should I even have the astigmatism part of the surgery done?


Answer: Fuch’s Dystrophy is a slowly progressive disease of the cornea in which the innermost layer of cells in the cornea, called the endothelium, tend to decrease in functioning and die, which makes the endothelium less efficient in maintaining the proper level of corneal hydration/dehydration through its normal metabolic pumping activity. This results in the cornea swelling and distorting vision and may be accompanied by glare, night vision problems, haloes and photophobia. You do not state what type of "astigmatism surgery" you are having with the Cataract Surgery. Presumably you are referring to the use of an astigmatism correcting toric lens implant and not Limbal Relaxing Incisions (LRI). The choice of a Toric Lens Implant rather than a Monofocal Lens Implant is generally not considered to pose any additional risk for a patient with Fuch's Dystrophy. One consideration is that although there are many experienced and excellent Cataract Surgeons, you may wish to consider have your surgery performed by a Cataract Surgeon who is also a Corneal Specialist. In this way, should it become necessary by using advanced corneal transplantation procedures that allow transplantation of the deep corneal layers called “endothelial keratoplasty” or “posterior lamellar keratoplasty” techniques it is often possible to help patients resume normal activities and lifestyles with minimal symptoms.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery & Macular Pucker

Question: Can Cataract Surgery cause or result in Macular Pucker or Wrinkled Retina?


Answer: A Macular Pucker or Epiretinal Membrane can occur due to changes in the Vitreous whereby cells converge in the Macular area creating a tight transparent layer that can cause the Retina to "pucker" like a piece of "cellophane wrap" when it is under tension. This may result in a "bowing" or "bending" of vision.

It is remotely possible that Cataract Surgery could lead to a spontaneous Vitreous Detachment-which is generally benign-which could then lead to a Macular Pucker. What is much more likely is that a fine Epiretinal Membrane existed before the Cataract Surgery and after the Cataract Surgery if a tiny amount of Macular Edema (swelling) was present it could have gotten trapped by the Epiretinal Membrane and caused the pucker. Some Cataract Surgeons order an Ocular Coherence Tomography (OCT) test routinely before the surgery in order to be sure there are no fine membranes present-and some do not as it is often not covered by insurance or Medicare when there is an otherwise "normal" Retinal exam and many patients complain about the added out of pocket expense.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.