Post-Cataract Surgery Complications: Retinal Detachment Insights

Retinal detachment after cataract surgery

Hello, doctor.
I have been following up on my cataracts at Cheng Ching Hospital for over three years.
During this time, I underwent laser repair for a retinal tear.
On April 17 of this year, I had cataract surgery and received a multifocal intraocular lens.
At my follow-up on May 9, I discovered a displacement and underwent another surgery to correct it.
I continued to have follow-up appointments, and on June 6, I informed the doctor that I felt an increase in floaters and a hazy sensation when looking at things.
The doctor diagnosed me with posterior capsule opacification, and two months later, I underwent laser treatment.
However, on the afternoon of June 7, I suddenly noticed a dark shadow in the corner of my eye.
During my follow-up on the Dragon Boat Festival, June 10, the doctor diagnosed me with retinal detachment with a retinal tear.
Since the lens is already implanted and cannot be treated with laser, I need to be referred to Taichung Veterans General Hospital for surgery.
However, due to the hospital being closed, I can only see a doctor on June 11.
I would like to ask:
1.
Is my condition related to my physical constitution? Is it related to the two surgeries? Am I unsuitable for cataract surgery since my left eye is still in the early stage of cataracts?
2.
Is there a smaller chance of displacement with a monofocal lens?
3.
Why do I need to be referred to another hospital for treatment?
4.
Given my current detachment condition, the doctor diagnosed that laser treatment is not possible.
What type of surgery would be suitable for me? What should I pay attention to post-surgery? Is it possible for my vision to return to normal? I am still relatively young, and I am really anxious.
How can I prevent recurrence?
5.
My job involves SMT operations, which require me to see small components.
Is this related to my condition? I apologize for asking so many questions; I am just scared and seeking clarification.
Thank you for your help, doctor.

Tian Xiansheng, 50~59 year old female. Ask Date: 2024/06/10

Dr. He Jianxian reply Ophthalmology

Dear Mr.
Tian,
1.
Since your eyes have not been examined, it is not possible to clearly determine your condition.
2.
A monofocal intraocular lens does not have a lower chance of displacement; rather, it has a greater tolerance for displacement.
3.
The referral is likely for addressing the issue of retinal detachment, as not every facility is equipped to handle retinal detachment cases.
4.
In the early stages of retinal detachment, if the area is small, laser treatment may be attempted; however, if the area is too large, laser treatment will not be feasible.
The choice of surgical procedure and the potential for vision recovery can only be determined by the operating surgeon, and it is not possible to make a judgment based on your description.
5.
It should not be significantly related.
Sincerely,
Director He Jianxian
Ophthalmology Department, Nantou Hospital

Reply Date: 2024/06/10

More Info

Hello! Thank you for reaching out with your concerns regarding your post-cataract surgery complications, particularly in relation to retinal detachment. It’s understandable to feel anxious given the complexity of your situation, and I’ll do my best to address your questions comprehensively.

1. Underlying Health Issues and Surgical Complications: Your experience with retinal detachment and the need for multiple surgeries may not necessarily indicate a systemic health issue, but rather a combination of anatomical predispositions and surgical factors. Some individuals have a higher risk of retinal detachment due to factors such as high myopia (nearsightedness), previous eye surgeries, or a family history of retinal problems. The fact that you had a retinal tear repair prior to your cataract surgery could suggest that your retina may be more susceptible to complications. However, this does not mean you are unsuitable for cataract surgery; it simply indicates that your case requires careful monitoring and management.

2. Single-Focus vs. Multifocal Intraocular Lenses (IOLs): Generally, single-focus lenses are less likely to dislocate compared to multifocal lenses, which can be more complex in terms of positioning and alignment. However, the risk of lens dislocation can still occur with any type of IOL, especially if there are pre-existing conditions that affect the eye’s anatomy or if the surgical technique is not optimal. Discussing your specific lens choice with your ophthalmologist can provide more tailored insights.

3. Referral to Another Hospital: The need to transfer to another facility, such as Taichung Veterans General Hospital, often arises from the need for specialized care or advanced surgical techniques that may not be available at your current location. Retinal detachment repair can be complex and may require specific expertise or equipment, which is why your doctor recommended this transfer.

4. Surgical Options for Retinal Detachment: The treatment for retinal detachment typically involves either a vitrectomy (removal of the vitreous gel) or scleral buckle surgery, depending on the extent and nature of the detachment. Since your doctor indicated that laser treatment is not an option due to the presence of a lens, surgical intervention will likely be necessary. Post-surgery, it’s crucial to follow your doctor’s instructions, which may include avoiding strenuous activities, maintaining a specific head position, and attending follow-up appointments to monitor your recovery. While it’s difficult to predict the exact outcome, many patients experience significant improvement in vision after successful retinal detachment repair.

5. Preventing Future Complications: To minimize the risk of future retinal detachments, regular eye examinations are essential, especially if you have risk factors such as high myopia or a history of retinal issues. Your ophthalmologist may recommend specific preventive measures based on your individual risk profile.
6. Impact of Your Work on Eye Health: Your job in SMT (Surface Mount Technology) requires precision and may involve prolonged periods of focusing on small components, which can lead to eye strain. While this does not directly cause retinal detachment, it can contribute to discomfort and visual fatigue. It’s important to take regular breaks, practice the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds), and ensure proper lighting to reduce eye strain.

In conclusion, your situation is understandably concerning, but with appropriate medical care and monitoring, many patients can achieve satisfactory outcomes after retinal detachment surgery. It’s important to maintain open communication with your healthcare providers, express your concerns, and seek clarification on any aspects of your treatment plan. Your proactive approach to understanding your condition will serve you well as you navigate this challenging time. Wishing you the best in your recovery!

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