Cataract surgery when you have retinal disease, is it safe?
Aug 08, 2024
'Caucoma', a representative geriatric eye disease, is a disease in which the lens becomes cloudy due to aging and the visual field becomes blurred, and according to the National Health Insurance Corporation's major surgical statistics yearbook', the number of surgeries performed by Koreans was 735,693 in 2022.
In general, the most obvious and only treatment for cataracts is surgery. However, if you have retinal diseases such as macular degeneration, diabetic retinopathy, retinal perforation, retinal detachment, and uveitis, you need to be careful because cataract surgery may not improve your eyesight or cause complications.
If cataracts are not severe, eye correction alone can provide effective vision, but the fundamental treatment is surgery.
The timing of surgery varies depending on the patient's condition, such as the degree of cataract progression, discomfort in life, and occupation, and if there is a retinal disease, it is important that the retinal disease stabilizes first before surgery.
Macular degeneration, one of the representative blindness diseases, is a disease in which waste products accumulate in the macula, a nerve tissue in the center of the retina, and gradually lose sight. In the case of macular degeneration, it is recommended to treat macular degeneration first unless the cataract is very severe. Cataract surgery is not a big problem even if it is delayed, but macular degeneration can change the prognosis as the treatment period is delayed. It is safe to undergo cataract surgery after at least six months to more than a year of no recurrence after treatment for macular degeneration.
Particular attention should be paid to blood sugar control when cataract surgery is required while having diabetes or diabetic retinopathy. If cataract surgery is performed without blood sugar control, diabetic retinopathy may occur or diabetic retinopathy may worsen, resulting in serious complications such as vitreous bleeding, neovascular glaucoma, and macular edema. Therefore, it is important to set the timing of cataract surgery by thoroughly controlling diabetes to stabilize diabetic retinopathy first, and then sufficiently consult a specialist. In particular, diabetic retinopathy may worsen after cataract surgery, so continuous examination and management are also important.
If you do not find retinal perforations with holes in the retina and perform cataract surgery, it may lead to retinal detachment.
If retinal perforation is found during the examination, laser treatment can first prevent the retinal perforation from progressing to retinal detachment, thereby reducing the likelihood of postoperative complications. If it is difficult to perform laser treatment on the retina due to a lot of cataracts, cataract surgery can be performed first and then laser treatment can be performed. However, retinal detachment can lead to blindness if you miss the timing of surgery, so if surgical treatment is required, the operation should proceed immediately regardless of cataract, and cataract progression tends to accelerate after retinal surgery, so surgery may be performed together depending on the progress of cataract.
Among the representative retinal diseases that should be noted when accompanied by cataracts, uveitis is the last.
Taking steroids to treat uveitis or performing injection therapy can speed up the progression of cataracts, so it is recommended to determine the appropriate timing of surgery with periodic examinations. In addition, if you have previously suffered from uveitis, uveitis can worsen after cataract surgery, so it is safe to proceed with cataract surgery after checking whether it is well maintained without inflammation for at least three months.
If a patient with retinal disease has immediate vision improvement after cataract surgery, retinal disease may worsen by neglecting to visit or manage. Conversely, retinal disease treatment can improve symptoms and neglect cataract management, but if it progresses to hyper-aged cataract or nucleated cataract, which hardens the lens, cataract surgery may increase and there may be unexpected complications. Therefore, if you are suffering from retinal disease and cataract together, it is important to visit an ophthalmologist periodically to check both cataract and retinal disease in order to improve the vision prognosis in the future.
"It is important to provide appropriate treatment through close examination and specialist consultation because unexpected complications or abnormalities can occur when accompanied by retinal diseases and cataracts," said Park Sae-mi, a specialist at Retinal Hospital of Kim Ophthalmology Hospital. "In particular, there may be too many cases depending on the degree of disease or eye condition, so it is more important than anything else to choose a hospital that has abundant clinical experience and can cooperate in both the retina and cataract fields."
In general, the most obvious and only treatment for cataracts is surgery. However, if you have retinal diseases such as macular degeneration, diabetic retinopathy, retinal perforation, retinal detachment, and uveitis, you need to be careful because cataract surgery may not improve your eyesight or cause complications.
If cataracts are not severe, eye correction alone can provide effective vision, but the fundamental treatment is surgery.
The timing of surgery varies depending on the patient's condition, such as the degree of cataract progression, discomfort in life, and occupation, and if there is a retinal disease, it is important that the retinal disease stabilizes first before surgery.
Macular degeneration, one of the representative blindness diseases, is a disease in which waste products accumulate in the macula, a nerve tissue in the center of the retina, and gradually lose sight. In the case of macular degeneration, it is recommended to treat macular degeneration first unless the cataract is very severe. Cataract surgery is not a big problem even if it is delayed, but macular degeneration can change the prognosis as the treatment period is delayed. It is safe to undergo cataract surgery after at least six months to more than a year of no recurrence after treatment for macular degeneration.
Particular attention should be paid to blood sugar control when cataract surgery is required while having diabetes or diabetic retinopathy. If cataract surgery is performed without blood sugar control, diabetic retinopathy may occur or diabetic retinopathy may worsen, resulting in serious complications such as vitreous bleeding, neovascular glaucoma, and macular edema. Therefore, it is important to set the timing of cataract surgery by thoroughly controlling diabetes to stabilize diabetic retinopathy first, and then sufficiently consult a specialist. In particular, diabetic retinopathy may worsen after cataract surgery, so continuous examination and management are also important.
If you do not find retinal perforations with holes in the retina and perform cataract surgery, it may lead to retinal detachment.
If retinal perforation is found during the examination, laser treatment can first prevent the retinal perforation from progressing to retinal detachment, thereby reducing the likelihood of postoperative complications. If it is difficult to perform laser treatment on the retina due to a lot of cataracts, cataract surgery can be performed first and then laser treatment can be performed. However, retinal detachment can lead to blindness if you miss the timing of surgery, so if surgical treatment is required, the operation should proceed immediately regardless of cataract, and cataract progression tends to accelerate after retinal surgery, so surgery may be performed together depending on the progress of cataract.
Among the representative retinal diseases that should be noted when accompanied by cataracts, uveitis is the last.
Taking steroids to treat uveitis or performing injection therapy can speed up the progression of cataracts, so it is recommended to determine the appropriate timing of surgery with periodic examinations. In addition, if you have previously suffered from uveitis, uveitis can worsen after cataract surgery, so it is safe to proceed with cataract surgery after checking whether it is well maintained without inflammation for at least three months.
If a patient with retinal disease has immediate vision improvement after cataract surgery, retinal disease may worsen by neglecting to visit or manage. Conversely, retinal disease treatment can improve symptoms and neglect cataract management, but if it progresses to hyper-aged cataract or nucleated cataract, which hardens the lens, cataract surgery may increase and there may be unexpected complications. Therefore, if you are suffering from retinal disease and cataract together, it is important to visit an ophthalmologist periodically to check both cataract and retinal disease in order to improve the vision prognosis in the future.
"It is important to provide appropriate treatment through close examination and specialist consultation because unexpected complications or abnormalities can occur when accompanied by retinal diseases and cataracts," said Park Sae-mi, a specialist at Retinal Hospital of Kim Ophthalmology Hospital. "In particular, there may be too many cases depending on the degree of disease or eye condition, so it is more important than anything else to choose a hospital that has abundant clinical experience and can cooperate in both the retina and cataract fields."
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