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Does cataract surgery increase the chances of retinal problems?

[caption id="attachment_1544" align="alignright" width="200"] Dr. Krawitz prefers the Alcon Infiniti phacoemulsification instrument for performing his cataract surgeries.[/caption] Cataract surgery is one of the most important processes with respect to maintaining eye health. With remarkable advances in technology accompanied by an optically demanding aging population, cataract removal has become more frequent and less arduous. However, research has shown that patients with retinal conditions may be prone to postoperative complications following cataract surgery. Cataract removal is vital in these patients because the presence of a clouded lens impedes a physician?s visualization and management of the retina. In a report from Dr. Samer Farah in the 2010 issue of the American Academy of Ophthalmology'sEyenet Magazine, the associations between preexisting retinal disease and the effects of cataract surgery were examined. Several retinal conditions and their relationships to cataract surgery were scrutinized. Recent studies have revealed that cataract surgery may exacerbate diabetic retinopathy, a common retinal condition in diabetic patients. Not only did cataract surgery increase the progression rate of the disease in subjects with a preexisting level of retinopathy, but it has also been associated with new occurrences of the condition. Patients with history of retinal vain occlusions (RVOs) are also susceptible to complications resulting from cataract surgery, primarily in the form of postoperative cystoid macular edema (CME). The risk of CME is also prevalent in patients with epiretinal membrane. With respect to age-related macular degeneration (AMD), results have been less conclusive. Due to the diversity of the disease, no accurate relationship has been established between AMD patients and postoperative retinal problems. The most common cause of retinal complications following cataract surgery is vitreomacular traction caused by movement of the vitreous. However, other mediating factors have been investigated. A particular study showed that patients with a high aqueous humor level of VEGF at the time of surgery were more prone to postoperative macular edema. As a result, anti-VEGF treatment via intravitreal bevacizumab is being used to prevent the onset of this condition. Other options for postoperative retinal care include the use of topical nonsteroidal anti-inflammatory drops (NSAIDS) and AREDS nutritional supplements. For AMD patients, physicians may choose to insert an ultraviolet light-blocking intraocular lens, for UV light is commonly thought to exacerbate AMD. Of course, these patients are also advised to wear sunglasses or hats as further means of protection after the operation. Certainly, cataract surgery is necessary to improve visual acuity, especially for patients with retinal diseases so that their conditions can be monitored without obstruction.? However, physicians must be wary that certain preexisting retinal diseases can make a patient more prone to complications following cataract removal. Hopefully, understanding the risk factors and employing certain methods of preventative treatment can minimize these postoperative effects. Brian Krawitz Staff Writer

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