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CME FOLLOWING CATARACT SURGERY: IS 2ND EYE SUSCEPTIBLE?
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onecat posted:
Hello - 77 yr old recovering from CME (just responded to your other post) ...what are the chances that the same complication will occur with the 2nd eye?
And considering the patient's history with the first eye are there any prohylactic medications/injectons, now available etc. to help prevent this condition ?
Thanks in advance for your kind help.
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Alan M Kozarsky, MD responded:
Yes, there is a increased chance of macular swelling on the second eye as well. We would certainly want the first eye to be at a state of maximum recovery before considering surgery on the second eye. That being said, it would be reasonable to consider using preoperative steroid and non-steroidal anti-inflammatory drops one or more weeks before surgery and for an extending time after surgery.
 
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onecat replied to Alan M Kozarsky, MD's response:
We intend to wait a long time regarding the 2nd eye ... per my other posts - 2nd eye has an above-normal OCT of 297/ 20/60 Snellen so patient is very apprehensive and will not agree to surgery at the present time...
We dont understand 'why' surgeon didn't operate on the eye that has the above reading of 20/60 & leave the 20/40 eye for the last ? (both read OCT 297 prior to first surgery). Thanks again
 
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Alan M Kozarsky, MD replied to onecat's response:
Why are maculas thickened? There seems to be another cause other than postoperative cystoid macular edema. Diabetes?? Pre existing macular pucker ??

In any case, cataract surgeons are commonly required to operate on cataracts in patients who have both cataract and macular disease. In such cases, addressing the cataract component of the decreased vision can be a source of visual improvement and care is taken to make sure that a macula is not adversely affected by the surgery.
 
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onecat replied to Alan M Kozarsky, MD's response:
Thank you for the above: Update ...there was/is pre-ex macular pucker !! (i didn't know this when i first posted)
Edema in post op-eye is now resolved after recent repeat OCT & during this visit to retina office, it is now suggested ''Vitrectomy' of ''pre-macular fibroplasia' on the post-op eye but did state only a 'mild-moderate' stage currently exists.
Cataract remains in other eye. There is no sign of any macular problems in that eye.
Would you suggest to first remove the cataract on other eye ''before' venturing into ''Vitrectomy surgery' to correct 'scarring' in post -op eye ? That procedure sounds it's not without many risks.
Snellen chart now measures 20/50 or 20/40 in both eyes, depending on different 'machines' in each office. These readings have not changed since January.
Opthalmologist cannot 'correct' operated eye any better than current 20/40 due to this existing macular -pucker problem in this post-op cataract eye . thank you again for your input -much appreciated.
 
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onecat replied to onecat's response:
10/1: ps from original 'poster' -(didn't want to start a new thread)
since i posted , Retina office called to inform us: - doctor would do a (quote) ' Membrane Peel' that would not require air/gas to replace vitreious-gel, but would use 'saline' therefore no requirement of ''face-down' position anytime post-op.
Told condition of pucker is ''mild-moderate' with no change of 'pucker' since first OCT(for edema status post cataract sy) in Dec. 2012.
Because of 'pucker' Vision cannot be 'corrected below) 20/50 -but assume same 'risks' apply for this 'membrane-peel'' as well as the ''vitrectomy' that uses 'gas/air' & requiring 'face-down' recovery time. thanks so much .


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