Answer: Cataract surgery and lens implants
for patients with diabetic retinopathy can be performed successfully for the
majority of patients but the ultimate results do depend on the overall health
ad condition of the retina in terms of the progression and degree of treatment
that has been rendered. First, it is critically important that a very careful
and meticulous preoperative retinal evaluation confirm the level of vision that
should be expected. One of the more common findings in diabetic retinopathy is
the presence of Diabetic Macular Edema (DME) which can have a considerable
effect of the level of best corrected vision that can be achieved-with or
without cataract surgery. It is likely that your eye surgeon rendering the
diabetic laser treatments is evaluating you for Diabetic Macular Edema with
fluorescein angiography and ocular coherence tomography (OCT) testing. The
presence of DME might actually be one of the reasons you are having diabetic
laser treatment currently.
Diabetic Macular Edema is often treated with laser
and/or vascular endothelial growth factor (VEGF) inhibitor injections such as
Lucentis® as well as other medications. One of the concerns that many diabetics
have is their susceptibility to slow or poor wound healing and infection.
Modern cataract surgery is typically performed using eye drops for anesthesia
rather than injections and through a very tiny self sealing incision-often
between 2.2 and 3.0 mm. The precision and the architecture of this tiny
incision allow it to close and heal without sutures in most cases. So, modern
cataract surgery is actually quite “wound healing friendly” and requires no
real modification in technique for diabetic patients. Depending on the stage of
diabetic retinopathy at the time of your cataract surgery and lens implants, it
is possible that your Cataract Surgeon or Retinal Specialist might place a
vascular endothelial growth factor (VEGF) inhibitor injection such as
Lucentis®, Eyelea® or Avastin® into the vitreous gel as a preventative and/or
therapeutic measure. Assuming that you will not have had any retinal or
vitreous hemorrhages prior to cataract surgery, and that the vitreous is
otherwise healthy, other than these considerations and as long as any presence
of macular edema has been accounted for in the setting of expectations for your
ultimate vision after the cataract operation-you should have a relatively
routine cataract surgery experience.
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 or 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. Contacting us via e-mail or any
other means is not a substitute for medical care.
