Question:
What is the data, what are people's experiences with cataract surgery and lens implantation versus using a contact after surgery?COMPLICATIONS????Infections, rejections, etc.Worse. Anybody know of other ways of removing cataracts?
Answer:
There are two basic ways to remove a cataract. One is to make a large
incision into the eye and remove the hard center of the cataract in one
piece. The second is to make a small incision (which may not require
sutures) into the eye and remove the cataract with a high-frequency
ultrasound device that breaks the cataract up into small pieces as it is
removed. Either method is compatible with implantation of a lens
implant.
A lens implant is placed at the time of surgery in over 99% of cases.
There has been no evidence of increased infection rate or other
complications associated with lens implantation, with the exception of
occasional lens dislocation requiring further surgery. This happens less
than 1% of the time. The alternatives to lens implantation are thick
glasses which work only if both eyes have similarly thick glasses.
Distortion from the lenses provides less than optimal peripheral vision
and image magnification. This magnification effect is the reason that
both eyes must have a similar need for strong lenses to avoid seeing
"double" (one big one and one little one). In addition, people without a
lens implant are usually very farsighted and can see nothing but shapes
and movement until they put on their glasses or contacts. A contact lens
is an option for those who have a single cataract removed without lens
implantation. Since most people with cataracts are older and some would
have difficulty caring for the lenses properly (especially if both eyes
had had cataract removal without implants and could not see well without
the contacts or glasses). The rarity of complications associated with
lens implants and the excellent potential for undistorted vision without
the need for contacts is the reason that lens implantation is almost
universal in the U.S. and in other developed countries. Cost is the only
reason that they are not truly universal.
The major potential complications of cataract surgery are bleeding and
infection which can be catastrophic. Such catastrophic complications are
quite rare, probably less than 1/1000 cases. Transient swelling of the
retina and retinal detachment are other potential complications which
occur more frequently, but are still relatively rare. In general, the
risk of complications limiting the final visual outcome significantly is
about 2-3%. Lens implantation does not affect the risk of these
complications.
