Risk of retinal detachment in high myopia if vitreous already detached

[mlouie]

I am 51 and have posterior subnuclear cataracts in both eyes and high myopia (around -9 left and -10 or -11 right). The cataract in my R eye is progressing and is now bad enough that I cannot read at all with that eye and it is affecting my depth perception and ability to drive at night (because of halos/rainbows). I have already had vitreous gel detachments in both eyes several years ago. The optometrist says my retinas and optic nerves look great. I understand that I should go to a retinal specialist before cataract surgery. My question is, does the fact that I have already had vitreous gel detachments reduce my risk of retinal detachment after cataract surgery, since the vitreous can no longer pull on the retina? I understand that high myopes have an elevated risk and I want to know if the previous vitreous detachment lowers my risk? The cataract in my L eye has not progressed in the past year and the myopia has improved a little, so I do not have to do surgery on both eyes at this point.

[AntonReiser]

Well I said the risk is very low if the PVD is complete. Can your PVD be complete?
You will also need the okay by a retinal specialist.
I found an ad video for OCT which showes the all side effects of high myopia. Maybe you want to see it:
http://www.retinarevealed.com/case-1-path-myopia.aspx

[Sandy Feldman, MD, MS]

Dear mlouie,

I would recommend that you seek the care of an eyeMD to assist you in determining whether cataract surgery is indicated at this time and whether you should seek care of a retinal specialist as well.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[AntonReiser]

I have another link for you:
http://doctor-hill.com/iol-master/iolmaster_tutorial.htm
It is about measuring the eye and the calculation of the power of the IOL.

[mlouie]

Thanks for the link; that is very interesting. As far as I know, the PVD is complete. I had the flashing lights when it was tugging on the retina for a a few days until the vitreous completed detaching. My more mypoic eye (R eye) did it first, then the L eye maybe a year later. The eye dr. told me to be careful about lifting and bending for a month or two while it was going on (to avoid retinal detachment). I have not had any symptoms since then, except I have a ton of floaters caused by the detachments which have not improved over the years. But the floaters are nothing compared to the cataracts--at least I could still see with the floaters.

[mlouie]

Well, I figured I could get a low powered lens in the R eye, so it would not be too different from the L eye (and continue wearing glasses). But if the risk of RD is very low and my insurance will pay for the L eye, I'll consider doing both eyes. I thought that insurance would not pay for the L eye until the cataract has progressed enough that my vision cannot be corrected with glasses.

[AntonReiser]

As a fellow myopic in similar age but not yet disturbed by my cataracts I like to tell you: If your vitreous has detached completely the risk of RD is very low.
Bu I think you have another problem. If you only have one eye operated there is an imbalance between the two eyes. It is very unlikely that your brain can adapt to two different pictures from two eyes with very different power.
So I think you will need to have both eyes done.