Reduce risk of retinal detachment in cataract surgery by not inserting lens?

I am fairly nearsighted and need cataract surgery in both eyes. My
surgery is scheduled for next Wednesday. My last prescription for
glasses was around 5-6 diopters in both eyes. I'm wondering if it
would significantly reduce the risk of retinal detachment by asking my
eye doctor to not insert a replacement lens but instead correct my
vision completely with glasses? Any comments or suggestions would be
appreciated. Thanks in advance!

 

Dear Mark,

Any operation on the eye entails risk.

At the point they must remove the "cataract" lens, the risk
is probably not changed to insert a replacement lens
at that point.

You should ask you MOD about this issue.

But the GREAT thing about that replaced internal lens
is that you get your distant vision BACK.

You will have a choice of very-sharp distant vision,
and some loss of near vision, or an "intermediate"
refractive state, of prehaps -1 diopter.

Best,

Otis

 

No it would not. If your retina is at risk, it's because your eye grew long

I was thinking that the less manipulation and jerking that my eye
undergoes, the more likely my retina will remain intact. Will the new
lens add any additional fluid pressure or shock waves on the retina
that could make it come loose? Also, without implanting a plastic
lens, I wouldn't have to worry about alergic reaction to the material.

-14 must be really thick glasses. I was thinking that my idea would
probably not be practical because the old lens capsule would not have
a well defined shape or a constantly changing shape that would affect
my vision.

 

Actually, NOT implanting a lens probably INCREASES risk of a retinal
detachment. The lens in place stabilizes the iris diaphragm, and reduces
forward movement of the vitreous, which is the factor thought to induce
retinal detachments by a tractional mechanism.

In addition, the implant reduces incidence of contracture and opacification
of the capsular bag, which would become more hazy and require a discission
of to open it, again increasing vitreous forward movement, and increasing
risk.

The iplant you need might be very low power, even plano, or in some cases
being a negative power. These lenses are made in such powers for situations
like this.

I will be operating on a -18 eye that is about 32 mm long soon - haven't
decided on the IOL power yet.


David Robins, MD
Board certified Ophthalmologist
Pediatric ophthalmology and adult strabismus subspecialty