Previous retinal detachment, blind in one eye

[whirlwind123]

I have had traumatic retinal detachments in my right eye had many surgerys, then completely blind in right eye.  Now the left eye had a small tear in the retina about 8 years ago and was repaired with laser.  Now the left eye has a very large cataract and I was told because of the risk to the retina and me only having one to put off getting the cataract surgery till basically there is no longer a choice., Went to  cataract specialist today and was advised a large cataract, can be removed and also said they now have other lens implants that help the astigmatism, and I would only wear glasses for reading.  My concerns are:  Is that lens more of a problem to implant and further cause retina detachment, then the normal one that I would still need glasses  for everything., the cosmetic part as far as not needing glasses is not a concern., my concern is losing my eyesight completely.  Is there any other precautions before or after surgery., is there more of a specialist I should be going to., I have gone to my retina specialist and another retina specialist and they advised it is up to me.....no one can guarantee anything., which I know., and all cataract specialist say., well it has to be removed., there is always a risk. which I am aware., but I need an opinion., or if anyone else had a similar situation.

[John C Hagan III, MD, FACS]

1. There are risks of leaving the cataract in too long including the cataract breaking up and causing lens induced glaucoma in the eye. Also if the lens becomes very hard (brown cataract) the risks of surgery go up.
2. Taking a cataract off always increase the risk of RD in everyone. No way around that.
3. I would get a second opinon from another cataract surgeon and another  retina surgeon then decide.
4. I would generally advise my patient to consider cataract surgery when the vision is a moderate or big lifestyle problem
5. What I do is have my patients see a retina MD before surgery to exam the back of the eye to see if preventive laser is needed, I give meticulous informed consent. I have the person see the retina surgeon one week after surgery for a dilated exam, then again at 4 weeks, then at 3 months then at 6 months then yearly.
JCH MD

[berrywoo]

Definitely take Dr. Hagan's advise. If you need anymore advice or support, there was a poster here who was monocular with a history of ROP (meaning she was at a high risk for RD) and about to undergo cataract surgery. You may want to look at some of her posts. I believe her "name" was mayalu.

[John C Hagan III, MD, FACS]

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