Question:
I am told that I have posterior subcapsular cataracts in both eyes. I
have also been told that I have nuclear cataracts, not posterior
subcapsular cataracts. I believe that the symptoms I exhibit more
closely match the posterior subcapsular cataracts, but am not sure.
I have a great deal of glare and have attempted to adjust my environment
accordingly with anti-glare screens on the computer, etc. I have lost
vision to 20/50 in one eye. The other eye can still be corrected to 20/20.
My eyes are highly myopic to begin with and I have a fairly strong
astigmatism. Are the surgical techniques different for removal
of a nuclear cataract vs. a posterior subcapsular cataract ? Is one type
of cataract more difficult to remove than the other or is the surgery
more risky for one type than the other ?
Answer:
Depends. Younger patients tend to have PSC type cataracts (50 and younger),
and nuclear sclerosis tends to be more common as an aging change in older
patients. This like anything isn't an absolute. I've seen 40 year olds
with advanced NS cataracts, but not that many in my 26 years in
Ophthalmology. A good surgeon should be able to remove either with an
extremely high percentage of success and with a very low risk of mishap.
Statistically, about 1/3 of cataract surgeries require YAG laser at a
future time, usually within the first few years. In my experience
those with posterior subcapsular cataracts and/or younger patients
(under 60), have a higher incidence of requiring a YAG. There have
been a variety of lens implant designs tried over the years to reduce
the incidence of posterior capsule opacification, but nothing has
really been successful in this regard. It has nothing to do with the
refractive power of the lens.
