Question:
Is there a scientific basis for his doctor's recommendation?
In other words, is color an indicator for the hardness or softness
of the cataract? If so, is Phacoemulsification inappropriate for
a hard cataract?
Answer:
Yes, a very hard cataract (what they used to call very ripe) is usually very
dark brownish in color.
The surgeon may feel that the PE may require too much power or energy to
break apart a hard cataract and that this can cause extra trauma to the eye
and much more than a straight ECCE will cause.
PE uses energy to break apart the cataract (sort of like a mini sound wave
jack hammer) and then the pieces are aspirated (sucked) out of the eye. It
is a very clean and less traumatic way to take out a soft cataract, but ECCE
may be better for a hard one. ECCE basically takes the whole lens out in one
piece.
Example: you have a big boulder in the middle of your precious flower bed
that you want to remove. You get your jack hammer out only to find it is
very hard rock and you have to get a super strength hammer and by the time
you are done the rock pieces and your constant presence has trampled and
destroyed your flowers. Now on the other hand you decide to dig a little
trench around it, tie a rope to it and get a small lift to just pluck it out
of the ground. You are now done faster and with less trauma to the
surrounding flower bed.
But, by all means get a second opinion if you want, but my guess is hat the
surgeon would rather do PE also but feels in this case ECCE is the better
procedure.
