Laser Cataract Surgery & Retinal Detachment

Question: I have extremely high myopia in my only working right eye -19 D. I function with my right eye only. My left eye is not really functioning after a retinal detachment many years ago. I am 53 years old and have a Cataract in my only working eye. I understand that there is a significant risk of retina detachment after Cataract Surgery in my right eye considering the degree of myopia and history of detachment in the other eye. I learned that recently the FDA approved a new laser based Cataract Surgery technology. Could it be less risky in my case?

Answer: Laser Cataract Surgery may prove to offer some benefits to patients in that under the direction of the Cataract Surgeon it applies femtosecond laser technology to increase the precision and reproducibility of a number of traditionally manual skill based steps. These steps include the placement of the initial tiny incision, opening the anterior lens capsule called capsulorhexsis, fragmenting or softening the cloudy lens material and placing fine incisions to correct astigmatism. Laser Cataract Surgery may offer greater precision for these steps but at the moment it is not clear that it actually does.In your instance, due to the high risk of retinal detachment, it is important to determine whether this technology might offer you a lower risk profile for Cataract Surgery. At the moment there is no clinical reason, experience or even theoretical reason why Laser Cataract Surgery would offer a lower risk profile in your case. One could theoretically "stretch" and argue that Laser Cataract Surgery is more gentle or perhaps lowers the necessary power settings and times necessary for the phacoemulsification procedure in the surgery-which is NOT performed with a laser-and perhaps this might decrease the risk profile. But at the moment there is no clinical evidence to support a superior risk profile for retinal detachment in your 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 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. Contacting us via e-mail or any other means is not a substitute for medical care.

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.

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. Contacting us via e-mail or any other means is not a substitute for medical care.

Blood Glucose Measures Can Predict Diabetic Retinopathy

Researchers from Institut National de la Santé et de la Recherche Médicale in Villejuif, France studied how glucose levels might predict the risk of diabetic retinopathy.The goal was to study the frequency of diabetic retinopathy in individuals 10 years after measuring baseline levels of fasting plasma glucose and hemoglobin A1C and to evaluate whether there were certain levels of the glucose measurements that could be used to predict whether patients would develop diabetic retinopathy. A clear relationship was found between certain threshold levels of fasting blood glucose level and hemoglobin A1C level and the predisposition to develop diabetic retinopathy. This information provides useful values for physicians treating diabetic patients to strive for in order to help patients with diabetes avoid the retinal complications of diabetes.


Archives of Ophthalmology: February 2011