Laser Cataract Surgery with High Eye Pressure

Question: My Mom is 60 and we are researching having a cataract surgery on her left eye. She has IOP of 26 and 28 in her left and right eye. She also has dry eyes. Is traditional cataract surgery better for her or is laser-assisted cataractsurgery better for her? We are looking for minimum complications or side effects, not necessarily best refractive outcome. She would be very happy with a bare minimum of complications.

Answer: The decision to have laser cataract surgery or traditional cataract should really be made with the cataract surgeon performing the procedure. BOTH types of cataract surgery provide excellent outcomes when performed by skilled surgeons. BOTH types of cataract surgery can have complications and side effects. Laser cataract surgery is highly reproducible and precise and gentler on the inner eye tissues. Your understanding of laser cataract surgery is correct-that it can temporarily elevate the intraocular pressure. Now, you do not state whether your mother has a normal optic nerve, normal nerve fiber layer and normal visual fields or whether she is actively being treated for glaucoma. IF upon visual field testing or Optical Coherence Tomography (OCT) there are any irregularities or defects, it is probable that her cataract surgeon will advise against laser cataract surgery. But, this is call made by the surgeon. Your best bet is to find the best cataract surgeon in your area and get their advice based on the specific findings during her cataract evaluation. Also-you mention that you are not seeking the best refractive outcome. You may want to reconsider this, as the goal of cataract surgery isn’t just to remove the cataract but to provide your mother with the best possible visual functioning-which does indeed require a precise refractive correction through proper selection of lens implants.

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