info on cataract surgery

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.

 

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.

 

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.

 

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.

 

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.

 

Yup,

Death would affect my (as they say) QoL.

Don W.

 

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.

 

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.

 

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.

 

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.

 

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?

 

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.

 

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...

 

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