Cataract Surgery Options After Vitrectomy: What You Need to Know

Q: Cataract Surgery Options After Vitrectomy: What You Need to Know

Hello, Miss： 1. The choice of cataract surgery technique is not significantly related to the vitreous surgery performed previously, and there are no specific restrictions on the selection of the intraocular lens. 2. Vision loss caused by macular traction may n

Cataract, lens?

Hello, I would like to ask: 1.
With a myopia of 600 degrees and having undergone vitrectomy due to vitreomacular traction, if cataracts develop afterward, can I choose femtosecond laser surgery? Or is only conventional cataract surgery an option? Is it true that after having vitrectomy, I can only choose a government-subsidized intraocular lens? I have read that the night vision with the subsidized lens may be poorer, peripheral vision may be distorted, and it lacks astigmatism correction.
Are there other types of intraocular lenses available for selection? 2.
For vitreomacular traction syndrome requiring vitrectomy, I currently have a vision of 0.5 with glasses.
I found online that doctors may suggest waiting until vision worsens a bit before proceeding with surgery.
If I delay the surgery and my vision either declines further or remains at 0.5, will the potential recovery of vision still reach above 0.5, possibly up to 0.8? Thank you.

., 30~39 year old female. Ask Date: 2023/10/02

Dr. He Jianxian reply Ophthalmology

Hello, Miss:
1.
The choice of cataract surgery technique is not significantly related to the vitreous surgery performed previously, and there are no specific restrictions on the selection of the intraocular lens.

2.
Vision loss caused by macular traction may not show significant improvement in some individuals after surgery; not everyone experiences a noticeable improvement in vision following the procedure.

Director He Jianxian, Ophthalmology, Nantou Hospital

Reply Date: 2023/10/02

More Info

When considering cataract surgery options after undergoing vitrectomy, there are several important factors to take into account, especially in the context of your specific situation involving high myopia and previous eye surgery.
1. Cataract Surgery Options Post-Vitrectomy: After vitrectomy, if you develop cataracts, you typically have the option to undergo either traditional cataract surgery or femtosecond laser-assisted cataract surgery (FLACS). Femtosecond laser technology can provide more precision in certain steps of the cataract surgery, such as making incisions and fragmenting the cataract. However, the choice between these options may depend on the surgeon's expertise, the specific characteristics of your cataract, and your overall eye health.
Regarding the choice of intraocular lenses (IOLs) after vitrectomy, it is not strictly limited to government-subsidized lenses. While insurance may cover basic lenses, you may have the option to choose premium lenses that offer better night vision, reduced glare, and astigmatism correction. These premium lenses, such as toric or multifocal IOLs, can significantly enhance visual outcomes, especially for someone with high myopia. It’s essential to discuss these options with your ophthalmologist to understand the benefits and potential costs involved.

2. Timing of Vitrectomy and Visual Outcomes: The decision to proceed with vitrectomy due to vitreomacular traction should be carefully considered. If your vision is currently stable at 0.5 (20/40), your doctor may recommend monitoring your condition rather than rushing into surgery. The rationale behind this is that surgery carries risks, and if your vision is stable, it may be prudent to wait.
If you do decide to proceed with vitrectomy, the potential for visual improvement post-surgery can vary. Many patients experience improved vision, but the extent of improvement can depend on several factors, including the degree of retinal damage, the presence of any other eye conditions, and the overall health of your retina. While some patients may achieve vision better than 0.5 (20/40), others may find their vision stabilizes at a similar level. It’s crucial to have a thorough discussion with your ophthalmologist about your specific case, as they can provide insights based on your retinal health and the expected outcomes of surgery.

In summary, when facing cataract surgery after vitrectomy, it is vital to have a comprehensive discussion with your eye care provider about your options, including the type of surgery and the choice of intraocular lenses. Additionally, understanding the timing of your vitrectomy and its potential impact on your vision will help you make informed decisions regarding your eye health. Always ensure that you feel comfortable with the plan and that all your questions are addressed before proceeding with any surgical intervention.

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