Covid 19 and cataract surgery

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I am 79 and have several pre-existing eye issues. ( previous tears, epiretinal membranes, cloud floaters, very slight macular in one eye, slight dry eye, etc.) I have been putting off cataract surgery and debating whether to continue to put it off due to the virus . Since at my age i am at high risk. also in Mass. which is finally beginning to come down in cases for the moment. I recently got a new glasses prescription and can see at 20/40. which is ok for driving. and it seems to be holding there for the last few months. I am basically not driving. I am pretty much home or outside due to the virus and my husband drives if we go out. Can read, can see distance enough, can use computer without glasses. Cataract surgery involves many visits back and forth to dr's office in addition to the surgery center for follow up, possible complications etc.Any thoughts on putting this off? What has anyone else done.

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  • Posted

    It is a very complex decision Joan, with many factors that only you can rationalize. COVID situation safety is certainly a factor. This is unlikely to change much over the next 12-18 months so you need to decide if you are willing to wait that long. Another is your general health, your anticipated life expectancy, life style, and the benefits that you expect to get from the IOL replacement. There could be a certain urgency to get this done.

    Yes, there are a lots of visits. I had the following:

    • initial visit with my eye doctor
    • measurement and consultation with the specialist
    • surgery in left eye
    • surgery in right eye two days later
    • post op check #1 with the surgeon 2 days later
    • post op check #2 with my eye doctor 1 month later
    • post op check #3 with my eye doctor after another month

      Some people do both eyes the same day so that could eliminate 1 visit. One of the post op visits may be need to get prescription for glasses, and the associated appointments. I also had PCO that involved 3 more visits, and my 6 month post op #4 is on hold due to COVID.

  • Edited

    hard decision. I would like to think hospitals and clinics are extra careful in their sanitization due to COVID19. As Chris mentioned there may not be a vaccine before you need this surgery. I would advise against having both eyes same day though.

    I was recently diagnosed with epiretinal membranes, Waiting to see a specialist - could be several months. Did you have surgery to correct that?

    • Posted

      The doctor I am planning to see doesn't do your eyes 2 days apart. More like 2 --3 weeks apart and others I might see are also several weeks apart. Re the epiretinal membranes I see a retinal specialist once a year for follow up re the pvd tear and the membranes and other retinal issues. More often if something flares up. Due to see him in fall (Maybe) . So far they have done nothing as not bad enough. But cataract surgery can make them worse.T

    • Posted

      It is better if you can wait 4 to 6 weeks between cataract surgery. during healing process vision can change so the surgeon cam make adjustments to 2nd surgery if needed.

      i was find for 2 years after cataract surgery - developed this EM issue less than a year ago. Not sure what will be done as hear due to risk the surgery only happens if it really affects your vision.

    • Edited

      There is a difference in opinion and confidence level between specialists. Those that are highly confident in their measurement equipment and their surgery skills have no reservation in doing the operation on the same day or a few days between. The benefit of the shorter time is the less time for the patient to deal with one eye still needing glasses, and the imbalance between the two eyes. You can make arguments for waiting weeks or longer between procedures. Like everything else in life, make your own decision and go from there. I was, and still am, happy with 2 days apart.

    • Posted

      Perhaps this various between countries but in Canada due to medicare system one would not be having cataract surgery 2 days apart. It's not a matter of confidence / skill of surgeon. There are things outside their control.

  • Posted

    My surgery is on hold due to COVID. Not sure I will get in this year or not. The time it takes to do one eye with all the COVID precautions has reduced the number of operations they can do to about 25%. Perhaps that will improve with time. My concern at this time is not the risk of getting COVID. My concern is more about my current better eye starting to go downhill. I will have a significant time between both eyes being done. My plan is to use that time to experiment with contact lens monovision using my current better eye for the closer distance focus. I am getting worried that if my "good" eye deteriorates too much I will not be able to give the monovision trial any kind of confidence that it would reflect what I get with monovision IOL's.

    • Posted

      Edmonton Alberta Canada. The whole cataract thing is in a bit of turmoil now in Alberta. The new government was implementing a system where cataract surgery could be done in private clinics and the backlog of those waiting for surgery reduced. Then just as they were about to do it, COVID hit. The impact of COVID on hospital admissions was far less than they were expecting, and now day surgeries are back on again, but of course the backlog has increased even more. I was originally roughly scheduled for August, but now as I say, I'm not even sure it will be this year. They seem to have very strict procedures they have to follow for each operation. Suspect they have to gown up, mask up, for each patient, then disinfect and dispose of the PPE and then gown up etc again. I'm also guessing they require a COVID test right before the surgery as well.

      A friend of a friend is a dentist and just reopened. He is apparently so frustrated by all the procedures they have to follow, that he has decided after only a few days, that it is time to retire. So he threw in the towel and did just that.

      But back to your original question, you would have to size up the procedures being followed in your area. I am quite comfortable going in during COVID here. My larger concern is the delay in getting this done, and whether my "good" eye will last long enough until I have the "bad" one done.

    • Posted

      Ron, when I had my surgery 9 months ago the specialist, assistant, and anesthesiologist were all in gowns, rubber gloves, face masks, and hair covering. I also had hair covering and was then completely draped with only a slit for the eye being worked on.

      The only additional measure would be a plastic face shield, for people in the OR with the exception of the surgeon who needs to have their eye uncovered so that they can look into the microscope.

      I do not know what the practice was for disposal of PPE.

      Hope you get an appointment sooner rather than later as there is the suggestion of a second wave.

    • Posted

      COVID has certainly created a backlog here in NB. Just got a call from my dentist. They can now do cleaning but not polishing. Not sure why. Also been waiting to have a follow up yo my skin cancer treatment at the hospital. Got a call today as they are bow seeing patients. Sure hope you don't have to wait much longer.

  • Posted

    Joan, I am 71 years old and I live in Connecticut. Our coronavirus cases and hospitalisations are very low, thank God. I had my surgery in a facility that just does eye operations. Everyone who is having surgery has to have a covid test before surgery. That reduces the likelihood that any patient has coronavirus. I do not know if the doctors or workers are tested, or how often they are tested. I wore a mask the entire time I was there, even during the surgery, and everyone else was wearing a mask. Hand sanitizer was available.

    It really depends on your own comfort level. If I lived in a state that has a high amount of coronavirus cases, I would not have it done.

  • Edited

    Hi Joan,

    Reading between the lines here, I think you've already made up your mind to put it off !

    I was in the same situation, and as I work for a medical company was able to ask advice. The advice I got, and this was back around May, and in the UK, was to put it off as long as possible for the following reasons:

    • less community spread
    • routine testing established for health staff, and patients pre admission
    • some hospitals established as Covid free
    • chance of better treatment if I were to get infected
    • best practices established in hospitals to lower risk

      In the UK, these factors now look better than they did two or three months ago, and I fear a second lockdown, so when I was offered a slot this week I jumped at it. However I am rather younger than you. I don't if / how these factors apply where you are. Only you can judge how badly it's affecting your lifestyle / how much risk you want to take.

      That doesn't really help does it ?

  • Posted

    I'm a "young" (59 y/old) person with rapidly declining vision due to posterior subcapsular cataracts in both eyes. I live just north of NYC in Westchester County, where COVID rates are increasing...The doctor has scheduled me for cataract surgery Dec. 23 and 30, as he encouraged trying to get it done before elective surgeries are potentially suspended again as they were in April 2020. I'm nervous--but going ahead. I'll be getting the Alcon Pan-Optix IOLs in both eyes. I have to have COVID tests in advance of each surgery. Surgery itself is done in a stand-alone ambulatory care center.

  • Posted

    I'm having surgery Jan18, but I have no choice (corneal transplant and cataract). I would say if it was me, and I could get by, I'd wait. Keep in mind you are in a high risk category. Not only that, but there is a a percentage of people that catch covid, easily get over it, but have long term complications (like me).

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