| Cataracts |
Question: Can cataract surgery cause a drop in IOP?
Answer:
Cataract surgery seems to wash out debris from the trabecular meshwork (this is most marked in pseudoexfoliation patients). When the capsule around the artificial lens shrinks [the artificial lens is smaller than the natural lens that was removed] and puts the ciliary body under more tension than usual, the pressure may go down for a year or more.
Dr. Rick Wilson
January 3, 2007
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Question: What is a yellow cataract?
Answer:
Almost all cataracts are caused by the aging of proteins to a more insoluble form. Just like old plexiglass, these proteins turn yellow with age.
Dr. Michael James Pro
October 4, 2006
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Question: Would you advise trying a new non-prescription eye drop that claims to relieve the symptoms of a diagnosed cataract?
Answer:
I suspect that it is not sufficiently tested and may be likely to do as much harm over the long term as good. The only non-prescription product I know that inhibits cataract formation, if taken consistently and starting before a cataract begins, is aspirin.
Dr. Rick Wilson
September 6, 2006
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Question: I am elderly and have pseudoexfoliation (PSXF) glaucoma. I need a cataract extraction as well as a trabeculectomy. Should I have them done separately or together?
Answer:
PSXF patients have more risk with cataract surgery than normal because of the weakened zonules with that condition. The risks of flat chambers and too low an IOP are uncommon with combined cataract and glaucoma operations, compared to trabeculectomies by themselves. To minimize the risk of an IOP rise after surgery, a combined trabeculectomy and cataract extraction is usually the better option.
Dr. Rick Wilson
September 6, 2006
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Question: I need an SLT and a cataract extraction. How should I schedule these?
Answer:
An SLT could be done either three or more months (my suggestion) before the cataract extraction, or three or more months after the extraction.
Dr. Rick Wilson
September 6, 2006
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Question: When is surgical dilatation of the pupil needed?
Answer:
Nowdays, surgical pupil dilation is done during cataract surgery in order to get the pupil wide enough to work on the cataract behind it. One can also have a pupil that is too small or pulled to the side because of congenital problems, earlier surgery, or trauma.
Dr. Rick Wilson
September 6, 2006
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Question: Can cataract surgery produce floaters?
Answer:
Yes. The natural spherical lens removed during cataract surgery is replaced with a thin, nearly flat lens. The jelly (vitreous body) that has been filling the back of the eye and that has shrunken with age then moves forward to take up some of the space abandoned by the normal lens. This puts serious traction on the retina and results in the floaters.
Dr. Rick Wilson
August 16, 2006
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Question: Would cyclophotocoagulation solve both my cataract and glaucoma problems?
Answer:
No, cyclophotocoagulation is only used for advanced glaucoma with poor vision, an endstage procedure.
Dr. Rick Wilson
April 4, 2006
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Question: When are cataracts removed?
Answer:
The lens is usually removed only when it is preventing the patient from doing activities that they need or want to do.
Dr. Rick Wilson
April 4, 2006
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Question: Can antipsychotic medicines cause cloudiness of the lens?
Answer:
Yes, some antipsychotic medications can cause cloudiness of the lens.
Dr. Rick Wilson
April 4, 2006
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Question: What problems may occur in cataract surgery on a very small eye?
Answer:
There can be injury to the inside of the cornea, since there is little room to work in a very small eye. Also, a very small eye is more prone to exuding fluid between the layers of the eye that can flatten the anterior chamber.
Dr. Rick Wilson
February 2, 2005
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Question: Do trabeculectomies always cause cataracts?
Answer:
In patients with a clear, that is, healthy lens, trabeculectomies rarely cause cataracts. The lens has no blood supply; a watery fluid furnishes oxygen and nutrients to it. In patients with an early or moderate cataract, that is, already diseased lens, the diversion of this fluid out through the new drain seems to accelerate the development of the cataract.
Dr. Rick Wilson
February 16, 2005
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Question: When I had a cataract removed from my left eye, a farsighted lens was installed. When I have the right eye's cataract removed, should I have a nearsighted lens installed so I will not need to wear glasses?
Answer:
If you have tried monovision, say with a contact lens, so that you know you do well with it, that is a reasonable course. If you have never tried it, I think trying it with an intraocular lens is risky in case your mind doesn't accept the different images.
Dr. Rick Wilson
February 16, 2005
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Question: Do glaucoma drops such as Lumigan increase the risk of cataracts?
Answer:
Not that we know. Steroids and very strong miotics like phospholine iodide can cause cataracts.
Dr. Rick Wilson
February 16, 2005 |
