info on cataract surgery

Discussion in 'Laser Eye Surgery' started by laggerlady, Mar 20, 2007.

  1. laggerlady

    laggerlady Guest

    hello,

    I am a 49 year old woman. When I was 29, i suffered a retinal
    detachment in my left eye. This was repaired with a silicon buckle.
    Two years later, \i had a detachment in my right eye, once again it
    was repaired witha buckle. Two years after that, \i develolped an
    allergy to silicon and had to have both buckles removed. \luckily,
    the car tissue has held everything in place since. About 10 years
    ago, i developed macular degeneration (wet form) in my left eye and am
    bacically blind in that eye. \now, i have started to get cataracts in
    both eyes. Aside from the fact that this all seems totally unfair for
    one person, I am wondering if there ia anyone else out there who has
    had so much eye problems!! The idea of more surguery is frightening
    as every surgery seems to take away a bit more of my precious little
    bit of vision. \i would appreciate any input from anyone who has
    experienced anything close to this.
     
    laggerlady, Mar 20, 2007
    #1
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  2. laggerlady

    smyers Guest

    You are right, this doesn't seem fair to have suffered so many
    problems with your eyes. My father-in-law is a retinal specialist and
    I asked him about your problem. He said it isn't that uncommon to see
    this combination of problems - he has several patients who have
    similar medical histories. He combines the surgery with medicinal
    treatments. He's based in Italy and developed Phototrop, which is an
    omega-3 based formula that improves the healing of the retina, plus an
    anti-inflammatory composition. Unfortunately, Phototrop is currently
    unavailable in the States. I myself am trying to get his formula on
    the U.S. market along with his new anti-inflammatory product, but that
    won't be until the Fall of this year, so I don't have an immediate
    solution for you. I hope you can use some of this information to help
    your doctor provide you with the best treatment.
     
    smyers, Mar 20, 2007
    #2
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  3. What's really surprising is that you got wet mac degen at age 39. I
    would think that is very uncommon and would recommend you do everything
    possible to keep yourself healthy (careful diet, regular exercize,
    etc). The early cataracts may have resulted from the other surgeries,
    but are relatively easy to fix. I would make sure the retinas are
    firmly "down" before going in (maybe a second retinologist opinion), but
    the surgery for cataracts is pretty simple and safe. Don't let them
    talk you into any kind of multifocal or "focusing" IOL.

    As bad luck as you've had, it's not the worst. Consider my patient,
    about your age, who went in for lower back surgery a couple of years
    ago. She had 20/20 vision both eyes. Came out of surgery totally blind
    in both eyes (4+ hours face down under general anesthesia apparently
    cause extremely low blood pressure that killed her optic nerves). Now
    she has a guide dog and is learning braille, but at least her house was
    paid for by the settlement. There's always someone in worse straits.

    w.stacy, o.d.
     
    William Stacy, Mar 20, 2007
    #3
  4. laggerlady

    Don W Guest

    I would make sure the retinas are
    The cataract consent form that I am looking at has the following
    statement, "The doctor has explained to me that there is even a
    possibility of some other complication occuring, which has not been
    specifically listed in this consent. In addition, as in any operation
    there is the rare possibility of drug reactions, serious bodily harm,
    or even death".

    It is nice to know the operation is "pretty simple and safe",
    otherwise.

    Don W.
     
    Don W, Mar 20, 2007
    #4
  5. laggerlady

    Charles Guest

    It is usually safe but they will cover themselves with disclaimers. And
    after all it is surgery. That is why you don't want to have it unless
    your quality of life is affected, like for example you can't drive.
     
    Charles, Mar 20, 2007
    #5
  6. laggerlady

    Don W Guest

    Yup,

    Death would affect my (as they say) QoL.

    Don W.
     
    Don W, Mar 21, 2007
    #6
  7. laggerlady

    Dan Abel Guest

    Been there and done that.

    I've had retinal detachments in both eyes. The buckle in my right eye
    is fine, although, there is astigmatism that isn't correctable. I've
    had cataract surgery in both eyes. I didn't get a buckle in my left
    eye, since it would worsen my vision. I see well. A good surgeon will
    not take away from your vision.
     
    Dan Abel, Mar 21, 2007
    #7
  8. laggerlady

    Dan Abel Guest

    The cataract consent form that I am looking at has the following
    statement, "The doctor has explained to me that there is even a
    possibility of some other complication occuring, which has not been
    specifically listed in this consent. In addition, as in any operation
    there is the rare possibility of drug reactions, serious bodily harm,
    or even death".

    It is nice to know the operation is "pretty simple and safe",
    otherwise.[/QUOTE]

    Crossing the street is simple and safe. Still, people die. Cataract
    surgery is pretty minor, but the consent form isn't.
     
    Dan Abel, Mar 21, 2007
    #8
  9. laggerlady

    Don W Guest

    otherwise.
    Cataract surgery is known to accelerate the onset of macular
    degeneration. Or make a present MD shituation worse. The operation
    may be simple but the surrounding conditions may make it unsafe.

    Don W.
     
    Don W, Mar 21, 2007
    #9
  10. Those are strong words. I don't think it's been established that cat.
    surg. accelerates the onset; in fact how would that be proven? It
    would have to be quite a study. And most MD patients end up with better
    vision post cataract surgery. The last sentence may be true for some
    special conditions, but the procedure remains very safe in good hands,
    and pretty risky in bad hands. You might be jumping to some conclusions,
    as you could say the incidence of death among cataract surgery
    recipients is higher than the incidence of death in the general
    population. That would be a true but meaningless statement, due to the
    age gradient. What would also be true but perhaps more meaningful is
    that people with cataracts live longer if they have IOLs installed than
    if they don't.

    w.stacy, o.d.
     
    William Stacy, Mar 21, 2007
    #10
  11. laggerlady

    Dan Abel Guest

    Cataract surgery is known to accelerate the onset of macular
    degeneration. Or make a present MD shituation worse. The operation
    may be simple but the surrounding conditions may make it unsafe.[/QUOTE]

    Then again, as the cataract progresses, the patient goes blind. How fun
    is that?
     
    Dan Abel, Mar 21, 2007
    #11
  12. laggerlady

    cdavis Guest

    I hadn't heard that cataract surgery accelerates MD. Both the wet and
    the dry? I had cataract surgery in my left eye a couple of years ago
    although I didn't see any difference in my vision after the surgery. I
    have the same prescription now as I had as a teenager. I had been told
    that I had 3 or 4 medium size drusen. Now they seem concerned about
    these drusen but they never told me that they could be made worse by
    surgery.
     
    cdavis, Mar 21, 2007
    #12
  13. I think the above was a gross exaggeration. There is some speculation
    that cataract surgery may affect the evolution of mac. degen, but to my
    knowledge it's never been pinned down very well scientifically. Most
    people with both mac. degen. and cataracts have their cataracts and do
    far better than if they just leave the cataracts alone...
     
    William Stacy, Mar 22, 2007
    #13
  14. laggerlady

    Don W Guest

    In some of the references relating cataract surgery and MD, there is
    a split as to their relationship. In one reference Dr. Wong (Ref 1),
    says, "The relationship between cataract surgery and ARMD has been
    inconsistent". And he cites the Beaver Dam Eye Study where they found
    a 5 year progression of MD (after cataract surgery). Then he
    cites studies where no associations have been found. Lundstrom (Ref
    2) in his study concluded that subjects in various stages of dry MD
    improved their visual function.
    Ambrecht (Ref 3) said QoL (Quality of Life) was maintained (Like "Do
    no harm"!) after cataract removal in mild and moderate ARMD group and
    no increase in rate of progression of
    MD.

    However, there is one paper by Kaiserman (Ophthalmology 2007; 114:
    278-282) titled "Cataract Surgery Is Associated with a Higher Rate of
    Photodynamic Therapy for Macular Degeneration"). He argues that the
    increased rate of PDT (due to increased rate of MD) is associated
    with the onset of cataract surgery and compares this between matched
    groups. That is, one group has cataract surgery and has a certain
    rate of PDT, and the other matched group does not have the surgery and
    has a lesser rate of PDT.

    The conclusion in all of this, it seems for me, is that if the
    cataract is minor and the MD is mild or moderate, you can expect
    improvement. But, if the cataract is not minor, and the MD non-
    minor , then cataract surgery my not be beneficial, and possibly do
    harm.

    Don W.

    Ref 1. Wong, Editorial. "Cataract surgery in patients with cataract
    and age related macular degeneration: do the benefits outweigh the
    risks"? Br J Ophthal 2000; 84

    Ref. 2. Lundstrom, "Cataract surgery and quality of life in patients
    with age related macular degeneration". B J Ophthal 2002; 86

    Ref 3. Armbrecht, J Cataract Refract Surg 2003; 29
     
    Don W, Mar 22, 2007
    #14
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