Question: I had cataract surgery in the 1970's for congenital cataracts and now I am considering a lens implant. I have vision in only my right eye, due to congenitial cataracts. I had both of my lenses removed via cataract surgery when I was a child. My question is that I have recently reconsidered the IOL, but during my appointment, my eye surgeon found scar tissue that has attached my iris to my lens capsule. He would like to try and remove the scar tissue using a procedure known as synechiolysis. Is this a feasible option?
Answer: Your Cataract and Lens Implant situation would be considered complex and technically challenging for any Cataract Surgeon. Adhesions or "synechia" can occur between the Iris tissue and Lens capsule in which case they are called "'posterior synechia" or can occur between the Iris tissue and the Cornea in which case they are called "anterior synechia". Synechia are a result of inflammation from infection, surgery and many other reasons. The procedure of Synechiolysis or "breaking the adhesions" is performed in a number of instances where the synechiae interfere with visual functioning. Sometimes it is possible to use a YAG Laser to perform some degree of synechiolysis whereas in other instances it must be performed manually with a spatula or blade. It is all a matter of degree.
Once the Iris has been returned to some state of normal shape and/or functioning it will facilitate the proper placement of a Lens Implant. Depending on the overall condition of the tissues in the "front" part of the eye, your Cataract Surgeon will be able to make the decision regarding what type of lens Implant should be used and what location it should be placed in. In addition to the general complexity of this procedure, the fact that you have vision only in that eye poses an additional need for preoperative diligence and care and meticulous surgical technique. That said, Synechiolysis is an established procedure and used by virtually all Cataract Surgeons as needed to provide optimal results.
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