Tough Cataract decisions after Retinal detachment
Posted , 7 users are following.
I am a 51 year old, highly myopic patient (left eye -14 and right -12). Both my retinas are generally weak but my left detached , most probably, due to tensile trauma to the left arm.
Recently I underwent a macula-on RD vitrectomy in my left eye without lens exchange. My lens is still clear. I am scheduled to remove the silicone oil inserted based on my request due to travel obligations in 3 months time.
I have multiple decisions to make:
1- should I go for an IOL in left eye even though lens may be clear? Pros include combined surgery and preempting the inevitable cataract. Cons include risk of retinal detachment.
2- for anisomotropia evasion, should I go for IOL in right eye shortly thereafter? Pros include anisomotropia evasion, preempting cataract in right eye to which highly myopic individuals are prone to sooner or later and better cosmetic appearance due to the need for light spectacles. Cons include risk of retinal detachment in right eye. Could IOL in left and toric contact lens in right be a permanent, comfortable option noting that I have dry eyes. Could it even be a temporary option until the risky 2-3 year period post-IOL elapse with no RD aftermath in left eye so i can go for an IOL in right eye with higher confidence and an overall mitigated risk profile for both eyes?
Awaiting your valuable advice and In advance I thank you for your kind efforts.
0 likes, 5 replies
Guest ash80493
Posted
Wow, that is a difficult situation...
My own story is, that I was born with cataracts, but I waited till the age of 45 with lens implants, at this time vision was so bad that I no longer had the choice of waiting.
In your case, I would probably wait with lens implants as long as possible, even that I fully understand why you are considering having it done now, you must be very bothered being that highly myopic.
If your vision is good with glasses or contacts, personally I don´t think I would risk the lens implants at this point. No one knows when you develop cataracts, it could be soon but it could also be in 10-20 years from now, and who knows what type of treatment are available at that time.
With iols you will probably get pco at some point in time, that will require fixing too, and you also risk other problems with the iols, beside the RD, such as visual side effects and so on, even that these side effects are not that common with monofocals, but some people do get these problems with monofocals as well.
What do the surgeon who made the vitrectomy say about it?
ash80493 Guest
Posted
Thanks Danish,
surgeon recommends IOL in left eye after 3 months of RD surgery.
ash80493 Guest
Posted
ps. 80% of RD surgery patients develop cataract within 2 years. So it is almost a miracle for it to come after 10 to 20 years. Is that why my surgeon recommends IOL early on? specially that I will have a silicone removal surgery in 3 months so he may want to combine both surgeries in one to spare me the hassle. what do you think?
Guest ash80493
Posted
I am a strong believer in listening to the surgeons advice, after all he/she is the expert.
So in this case, I think I would follow that recommendation, I did not know that you would expect cataracts this early after your current treatment.
And whether to have the other eye fixed as well, is not something you need to decide now, you can see it works for you, and then decide.
In any case, I wish you the best of luck 🙂
soks ash80493
Posted
a coworker of mine has had both his eyes have RD and both repaired. this was in 2008. he was also told to expect cataract within two years. but he hasn't had them in either eye until now. also he says that his vision in the first eye where the RD was detected a little late is better than the second eye where he got it treated immediately as he knew immediately what was happening.