High Risk Patient for Cataract Surgery

I have a number of issues that might cause my vision to worsen after the cataract surgery and I was wondering if it really would.  First, I have had 20 hours of radiation treatment on my forehead as a cure for allergies a long while back.  Second, I have flashing in my eyes called arching but my specialist has told me that it is not an indication of retinal detachment.  Furthermore, I have allergic and dry eyes which might affect post operative care of my eyes.  Lastly, I have a history of macular degeneration.  I have read that cataract surgery would increase my risk of macular degeneration.  My question is are these factors going to pose as serious threats to my vision/health after or during the cataract surgery?

Thank you!

[John C Hagan III, MD, FACS, FAAO]

1. If the radiation portal passed through your eyes it could have caused cataracts and radiation retinopathy. If radiation will affect the eye normally the therapeutic radiologist will inform you and have you sign a conscent that your understand the threat to your sight. If you do not recall that being listed likely they did not treat through the eye. They make every effort to avoid the eye.

2. You are describing a posterior vitreous detachment. That should not be a factor. You can use the search feature on this page and learn more about PVD.

3. Allergic and dry eyes may make your eyes redder and more irritated post operatively but frequent use of artifical tears should take care of that. Its not likely to have any major effect on your surgery.

4. Macular degeneration is a BIG deal. Any part of your reduced vision due to macular degeneration will not be helped by the cataract surgery and macular degeneration is the most common reason that an eye fails to recover "normal" vision after surgery.   There is no conclusive proof that cataract surgery makes macular degeneration worse. They are both degenerative problems and they both occur more often as we age.

You should try and clarify with your surgeon how much macular degeneration you have and you should compare your post op vision with what it was before surgery, not what it was 30 years ago or what a friend of yours got after they had cataract surgery when they did not have macular degeneration.

JCH III MD   EYE MD