This article is more than 5 years old. Information may no longer be current.
Cataract surgeons can help avoid retinal problems in high-risk patients
Click Here to Manage Email Alerts
|
WAIKOLOA, Hawaii — Cataract surgeons can avoid inducing retinal complications by identifying high-risk patients and adhering to a few basic criteria, said Kirk H. Packo, MD, during a symposium here at Hawaii 2005, The Royal Hawaiian Eye Meeting.
Pseudophakic patients are at a higher lifelong risk for retinal detachment than the normal phakic population, Dr. Packo said. Cataract patients who are at higher risk for retinal detachment include young, white males with moderate to high myopia and a family history of retinal detachment, Dr. Packo said. Also, patients with posterior subcapsular cataracts (PSC) tend to be at higher risk, possibly due to the need to polish the capsule, he noted.
Dr. Packo offered two main tips to cataract surgeons whose patients might need to be referred to a retina specialist.
“How do you make a retina surgeon happy? Avoid silicone IOLs and small capsulorrhexes if you’ve got a patient from that young, high-myope, lattice-PSC high-risk group,” he said.
Silicone oil used during retinal surgery adheres to silicone IOLs, “so I have to take the silicone implant out anyway,” Dr. Packo said.
Dr. Packo said a small capsulorrhexis obstructs the retinal surgeon’s view, requiring him or her to cut the capsule away.
To successfully reattach the retina and restore vision in these patients, Dr. Packo said it is advisable to do a primary vitrectomy and not a scleral buckle. He said it is logical to do a vitrectomy in order to clear vitreous traction and to avoid postoperative floaters.
Dr. Packo concluded by asking the non-retina specialists in the room: “Have you hugged your retina specialist today?” The relationship between the retina specialist and the cataract surgeon should be symbiotic, he said.
“Make life easy for me, and I promise I will continue to tell my colleagues to do procedures like vitrectomies, so we can send patients back to you … to be properly refractively corrected,” he said.