Do You Need Additional Eye Exams Before Cataract Surgery?

Q: Do You Need Additional Eye Exams Before Cataract Surgery?

Hello： Before cataract surgery, the physician will conduct a series of examinations to assess the macula, optic nerve, and other factors. <br>Regarding the choice of intraocular lens (IOL), considering your macular degeneration and work requirements, it is recommended that you se

Do I need to undergo examinations for the macula, glaucoma, or other conditions before cataract surgery?

Hello Dr.
Gao.
My left eye is 1700, and my right eye is 2400.
Both eyes have presbyopia, astigmatism, and macular degeneration, with the right eye being more severe and requiring cataract surgery.
I would like to ask Dr.
Gao if I need to undergo additional examinations for the macula, glaucoma, or other conditions before the cataract surgery (I had these tests done two years ago), or if I only need to have the pre-operative assessments the day before the surgery? Additionally, since I have macular issues, is there anything specific I should pay attention to when choosing the intraocular lens? I work with computers and reading, should I reserve a specific prescription for after the surgery? If I do reserve a prescription, will I still be able to wear contact lenses in the future? Thank you, Dr.
Gao!

Pan, 50~59 year old female. Ask Date: 2024/02/15

Dr. Gao Pilin reply Ophthalmology

Hello: Before cataract surgery, the physician will conduct a series of examinations to assess the macula, optic nerve, and other factors.
Regarding the choice of intraocular lens (IOL), considering your macular degeneration and work requirements, it is recommended that you select a suitable artificial lens under the guidance of your attending physician.
Some advanced IOLs may better meet your visual quality and demands.
You can ask your attending physician if there are multifocal or other specially designed IOLs available to address your visual needs, especially for computer use and reading.
As for the prescription, the attending physician will determine the most appropriate IOL power based on the surgical requirements and your visual condition.
After the surgery, it may take some time to adapt to the new prescription.
If a residual prescription is left, you may need to use glasses during the adaptation period instead of contact lenses.
You can discuss with your ophthalmologist after the surgery when it would be appropriate to consider using contact lenses to ensure your eyes have fully healed.

Reply Date: 2024/02/15

More Info

Before undergoing cataract surgery, it is essential to have a comprehensive eye examination to assess not only the cataract but also any other underlying conditions that may affect the outcome of the surgery. Given your history of high myopia, presbyopia, astigmatism, and macular degeneration, additional evaluations are crucial for ensuring the best surgical results and visual outcomes.

1. Additional Eye Exams: While you mentioned that you had exams two years ago, it is advisable to have updated assessments of your macular health and intraocular pressure (IOP) to rule out glaucoma. Conditions like macular degeneration can significantly impact your vision post-surgery, and knowing the current status of your retina is vital. Your ophthalmologist may recommend tests such as optical coherence tomography (OCT) for the macula and visual field tests for glaucoma. These tests will help determine if any additional precautions or treatments are necessary before your cataract surgery.

2. Choosing the Right Intraocular Lens (IOL): Given your existing macular condition, selecting the appropriate IOL is critical. You may want to discuss options such as multifocal or toric lenses, which can help correct astigmatism and presbyopia. However, the presence of macular degeneration may limit the effectiveness of these lenses, so it’s essential to have a thorough discussion with your surgeon about the best choice for your specific needs. Your surgeon will consider your visual demands, such as computer work and reading, when recommending the IOL.

3. Preserving Post-Surgery Vision: Regarding the need to reserve a specific prescription for post-surgery vision, this is a common consideration. If you have a particular visual requirement for your work, it may be beneficial to discuss with your surgeon the possibility of leaving a slight degree of myopia or hyperopia in your surgical plan. This could allow for better near vision, especially if you frequently use computers or read. However, this decision should be made based on a thorough understanding of your visual needs and the potential impact of your macular condition.

4. Contact Lens Use Post-Surgery: After cataract surgery, many patients can wear contact lenses, but this will depend on the stability of your vision and the health of your eyes post-operatively. If you choose to reserve a degree of myopia, it may affect your ability to wear contacts comfortably, especially if you opt for multifocal lenses. Your eye care provider will guide you on when it is safe to resume wearing contacts after surgery.

In summary, it is crucial to have a comprehensive eye exam before cataract surgery, especially considering your complex eye health history. Discussing your specific needs and concerns with your ophthalmologist will help ensure that you receive the best possible care and outcomes from your surgery. Always feel free to ask questions and express any concerns you may have during your consultations, as this will help you make informed decisions about your eye health.

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