Mental aspects of cataracts/twitching eyelid

[Capes55]

I'm the 53 yr old Male High Myope (29mm axial length) with a posterior subcapsular cataract in my right eye.  I've been considering  surgery for about a year.

Can anyone relate to this?  My cataract is considered Mild (that's what a Houston retinal specialist told me)  BUT

It's in my field of vision almost constantly.  When I look left to right or right to left,... it's there...partially transparent, but there....it's on my mind almost constantly during waking hours, because I see it all day long, who knows how many times...too many for sure,

Also, very tough to read from that eye, colors not as bright, distance vision not too bad (probably around 20/30 as long as I'm wearing my toric contact lens (which is rather thick and uncomfortable)

Because I'm so constantly aware of my cataract, it's having an adverse effect on me mentally, primarily  the constant distraction.

Those of you who have had successful implant surgery, was your problem solved right away, and thus, immediate relief?



Did you feel the long term benefits outweighed the risks?

I feel like the only way I'm going to have a significant chance of peace of mind over this matter is to take the plunge and have cataract surgery.

I'm in a high risk category for RD, however I've been told by several MDs that it appears that my vitreous is completely detached in my problem eye, which they say, is a god thing, and lessens the risk.

Does anyone know how frequently (like what%) capsular bags are torn in cataract surgeries?

I'm just looking for some relief, but I'm also trying to be as well informed as possible.

I've narrowed my choice of prospective surgeons to 3
#1 A local MD, very experienced, does surgeries 2 days a week, Mondays and Thursdays, has been in business around 25 years, is very confident, I don't think is board certified. Solo practitioner, has an O.D.that works with him in the same office.  this guy also does Lasik and PRK

#2 Another local board certified MD, also a solo practitoner, around 40 years old, just built a beautiful office, with state of the art, brand new equipment...specializes in Cataract surgery only...does surgery on Wednesdays only, I've heard he does 10-12 surgeries each Wednesday.

#3 A renowned Houston MD who is in his early 50's, well respected, speaks at a lot of conferences, on the Faculty (I think) of a major medical school, does corneal surgery, cataract surgery, and I'm pretty sure, Lasik and PRK.
I believe he also does his surgeries on Wednesdays.  I spoke to his head technician recently who told me had performed 10 surgeries on a recent Wednesday, 2 were cornea and 8 were cataract. He is well known in the region.


Any suggestions on who to pick..pros/cons?

Finally...1 last question...my right eyelid (my bad eye) has been twitching off and on for about 6 months,like several minutes each hour..Several O.D.s told me it was probably stress, caffeine etc. I don't use caffeine and I don't think my stress level is higher than normal, although my preoccupation with my cataract may be a factor.. Anyone know of any cures? suggestions?

One of the Mds I'm considering said no vitamin E for 2 weeks prior to surgery...anyone been told this?

Thank you in advance to any of you who can offer any help/suggestions.

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

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[JodieJ]

Although everyone is different, wearing a contact lens in one eye between surgeries does work for some high myopes.  In the google group sci.med.vision, "Dan Abel" (screen name) described his experience of going several years between cataract surgeries being plano in one eye and -10D in the other eye.  He reportedly wore a contact in one eye for about 14 hours a day.  The remainder of the time he wore "monovision" glasses.  I was very comfortable wearing a -6.75 contact lens in one eye after I had my first eye done.  I'd suggest that you try this option before rushing into surgery on your second eye.  

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

1. Contact lens may not be enough to overcome the image size in the two eyes.
2. If a PVD is totally detached from the retina yes it reduces the risk but it's hard to tell and most often still remains attached at what's scallle "the vitreous base".


JCH MD

[Capes55]

I forgot 1 question...Does a detached vitreous lessen the risk for RD?  Thanks

[Capes55]

Dr. Hagan,

Thank you again for your help.  1 question..concerning the need to have both eyes done...I wasn't planning on it....I wear contact lenses...I've been told by several ODs that a contact lens on 1 eye and an implant in the other eye shouldn't cause any problems.  Do you agree?

I know that if I have cataract surgery on 1 eye only, then glasses will not be an option.

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

1. You should only have surgery if you think it's a BIG problem. Don't do surgery if its a little or medium size problem. You will have to have both eyes done or they won't be balanced (not at the same time about 4-8 weeks apart). Your risk of retinal detachment is about 10% in each eye.
2. Capsular's tear about 2-5% of the time. If that happens the risk of a RD may be as high as 15%.
3. You alone should decide on which surgeon you feel best about.
4. Vit E can increase the risk of bleeding (risk is LOW) but some surgeons stop it.
5. You lid problem sound like "myokymia"  use the search feature and look up the many discussions about it. Not due to stress or most everyone would have it.

JCH IIIMD