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Fully discuss cataract surgery risks with patients who have compromised corneas
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NEW YORK — In patients with compromised corneas, the secret to a successful cataract surgery outcome is a lot of time talking with the patient, preparation and a careful surgical technique, one surgeon said here.
In a presentation at OSN New York 2009, John A. Hovanesian, MD, gave pearls for cataract surgery in the compromised cornea. "Patients with endothelial disease deserve some special attention," he said.
Dr. Hovanesian said it is important to discuss in detail all of the risks involved and why the patient with a compromised cornea has those risks.
"The patient undoubtedly will be asking themselves, 'Well, all of my friends had perfectly simple cataract surgery. Why is this doctor telling me this? Doesn't this doctor know how to do this surgery?' and we have to explain this to them," he said.
"One of the things I've found that's helpful is to give patients a percentage chance," Dr. Hovanesian said. "People like to hear what the likelihood is that they're going to have complications. Of course there's some guesswork in that. I tend to overestimate the chance."
Dr. Hovanesian also recommended a return visit with the patient to discuss the challenges again. He encourages patients to visit www.fuchsdystrophy.com, where they can get into discussions with other patients in similar situations.
"Something I always think of is that if you tell the patient about it ahead of time, whether it's endothelial cell count or something else, they think of you as a genius," he said. "If you tell them afterward, you're making excuses, which is something I got from David Bogorad, MD, who was one of my mentors."
OSN New York 2010 will be held November 19-21, 2010 at the Sheraton New York Hotel & Towers in New York City. Learn more at OSNNY.com.