Vitrectomy-Cataract

[homecrafter]

Hello everyone !  
How fast, typically, does a cataract form after a vitrectomy/ERM peel ?

If I went from "Trace" pre-surgery to 2+ 4 months post surgery...would it be logical to think it will continue
advancing at approx. that rate?

  My "OCT central thickness" number is 385, so I don't think my eye is ready for cataract surgery?

Thank you for any suggestions or shared experiences !

[JohnHaganMD]

Given the way you posed the question I can't tell what the surgeon is proposing. A vitrectomy causes the natural lens to develop a catarct but not an IOL. You will need to clarify what your surgeon is proposing with him/her.
JCH MD

[JohnHaganMD]

That response was from 2011 and doubt you get an answer. About 70% of people that have their natural lens have cataract surgery within 2 years of the vitrectomy

JCH MD

[Aparajithan]

Had cataract surgery in left eye. Foldable IOL implanted after phacoemulsification of cat acted natural lens. Have corneal dystrophy 3 or 4 years old. Eye surgeon did YAG laser vitreolysis. He says there is still a small bit vitreous left which he says can be removed by a minor surgery. Is this same as vitrectomy and if so will cataract develop again? Would be thankful for advice.

[marlasjules]

my cataract was visible immediately after victrectomy where before it was nill. Dr said gas was culprit but who knows...now i am 3,5 months past victrectomy and it's about the same..wonder how bad it gets.,
Did you have the cataract surgery?

[homecrafter]

Thank you so much for your responses, and yes I too appreciated all of jodies wise and thoughtful comments.  

May I ask how you had your one IOL set?  I.E. for distance, intermediate, or near?   Monofocal ?

My good/ non-surgery eye is still good for distance and intermediate and only has a 1+ start of a cataract, so I will hope to leave it alone for 5 maybe 10 years like you.
Therefore, we seem to be in the minority where we only have one eye done with an IOL.  
I am 56 and just wear reading glasses, although my surgery eye is now 20/400 with best corrected to 20/50 right now with the 2+ cataract in it.  
I don't mind wearing reading glasses but I would like to see distance and intermediate (where I see peoples faces and things on store shelves, etc.).

I am confused as to how to adjust the IOL in my cataract eye when I have this upcoming surgery , to get to that outcome.
What did you do and why ?  Are you happy with the results ?

[SparklyOats]

Hi, homecrafter,

My cataract was removed successfully using a phaecoemulsion technique.  My friend's cataract was also removed successfully, but I don't know if they used the same technique.  

My surgeon had "done" a friend of mine a couple of years ago and at that time, he was in his late 60s. I also looked up reviews of cataract surgeons and found that she was meticulous and highly regarded etc.  (My health plan originally had me going to another surgeon based on what time I could make the appt [Hobson's choice, I guess].  I looked him up and saw he had negative reviews and people called him "untrustworthy" & a "poor communicator" so I bailed out, researched more, talked with people I know, and found the surgeon I love!)

I asked my surgeon if she had any experience with IOLs in people who had prior vitrectomy/ERMs and yes, she had a lot of experience with that, which also helped calm my fears. There are just such advanced techniques now to put in the IOL that there were no stitches, sutures or "eye glue" because of the way they do things.  I was instructed to wear the eye patch home, then I could take it off. No pain, no discomfort at all.  I think the worse thing for me was them finding a vein for the IV.  I'll be 61 next month.  

Let me know if you have any questions, as I'm glad to help.  There is a tiny cataract in my other eye, and my surgeon says it'll take maybe 5, maybe 10 years to get to the point of where I want it removed. I know Jodiej's post certainly always helped me, and I'm glad to, in turn, help others.

Sparkly

[homecrafter]

Thank you for your response...it is just nice to know that 4 months post surgery Cataract is NOT out of the ordinary.

Did you have your Cataract removed successfully ?  Did your friend ?
I've read that Cataract surgery after Vitrectomy/ERM peel is much riskier than normal.  I am in the beginning stages of researching Cataracts, lenses, and IOL targets.  I will only do my ERM Surgery eye, as my other eye is still only a "trace" Cataract. (I'm 56 yrs old)

Would love to hear any of your experiences SparklyOats, or anyone elses !
THANK YOU ALL for sharing, this helps more than you know.    

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

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[SparklyOats]

Hi,

For me, it took about a year for my cataract to develop to the point where I was affected in my daily living--this was post-vitrectomy/ERM.  For a friend of mine, who lives a number of states away--she also had a vitrectomy/ERM-- it took 4 months for her cataract to develop to the point where it was affecting her daily living.

All in all, I believe that any time within a year of your vitrectomy/ERM, that cataract will develop (that's what I read, anyway).

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

I'm sorry I cannot answer either question and the information must come from your retina surgeon.

JCH MD

[homecrafter]

Thank you Dr. Hagan for your response.  Unfortunately, I must have worded my question wrong as I do realize a cataract was likely after Vitrectomy.

My question is.this:  My Retina Surgeon said my post surgery forming cataract was already a 2+  at my 4 month post surgery appt.

1)  Is that an unusually fast cataract progression post Vitrectomy considering I was only "Trace" pre-surgery ?

2)  Also, my OCT macular edema central reading is 385 at 4 month post surgery (595 pre surgery:  455 One month post surgery)  
I am not on any eye drops or anything.  How long can these high readings go before someone needs to be concerned about whatever bad side effect the high readings cause ?  
( I know the edema reading is independent of the cataract issue, but was told NOT to even consider cataract surgery until my eye "settled down"...whatever that means)

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

OCT central thickness has nothing to do with cataracts.  Cataracts would be measured by how well you read a visual acuity chart and your level of cataract caused visual disablity.

Many to most people with vitrectomies have cataracts, often requiring surgery, within 6-12 months.

JCH MD