Surgeon: Be aware of surgeries performed by other subspecialists

Klaus Lucke, MD, said refractive surgery can inadvertently impact future retinal surgery.

NUREMBERG, Germany — Refractive surgeons should pay more attention to how their surgeries affect the work of retinal specialists, according to one surgeon. For instance, refractive surgery can compromise the fundus view, Klaus Lucke, MD, said here at the German Ophthalmic Surgeons meeting. “This is a complication,” he said. He said he was particularly concerned with refractive lens exchange, which he said hinders vitreoretinal surgery.

“Myopic eyes get tears and they need treatment, so we need a good fundus view,” Dr. Lucke told attendees.

Preserving the diaphragm will help reduce the risk of postoperative retinal detachments, and he requested refractive surgeons use narrow haptics because retinal surgeons work almost exclusively in the periphery. The capsulorrhexis must be at least 6 mm in diameter, he said.

Dr. Lucke said another potential problem is cystoid macular edema.

“Patients have it after cataract surgery so why not after refractive lens exchange?” Dr. Lucke said.

During LASIK surgery, removing the suction ring too quickly can lead to retinal problems for the patient as well, Dr. Lucke said. For instance, during suction the eye becomes longer, and when the suction is released, the eye becomes shorter and wider. A rapid increase in the width of the eye can result in retinal detachment, he said.

“Avoid sudden decompression,” he urged.