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First of all many thanks for all your wonderful help .. pt. 77 yr old male...20/40 prior to cataract removal; 1st p.o. day couldn't read Snellen. sent to retina sp
onecat posted:
First of all many thanks for all your wonderful help ..
pt. 77 yr old male...20/40 prior to cataract removal;
1st p.o. day couldn't read Snellen. sent to retina specalist.
4 days post-op -steriod injection done after first OCT .
6-wk repeat showed OCT 350 to 295 (Snellen initial 20/400 to current 20/40). No add'l injection suggested, pt. discharged back to opthalmologist

Current three-month post-op is 20/40 & opthalmolists & has been the best to date.. told to wait another 3 months (will be 6mos P.O.) 20/40 maybe be best but if no improvement in 3 mos may suggest return to retina office repeat OCT
Bottom line, if pt ends up with same reading 'after' cataract removal as before (20/40) then 'why' have a cataract removed ? (i hope this isn't a 'silly' question') ..also both eyes prior to and after read the same on the OCT (higher than average) is it possible one can have 'higher' than normal readings (ruling out any other problems? ) many thanks in advance for your kind help.
Alan M Kozarsky, MD responded:
Not sure whether you are asking why, in retrospect, was the cataract removed if vision post op was going to be the same as vision pre op. Answer to that is that this sometimes occurs due to post op surprises such as macular swelling.

If you are asking whether the patient should have the cataract in the other eye then the answer will depend on how cloudy the cataract is, whether the macula in the unoperated eye appears normal on exam and OCT imaging. If a bad cataract in second eye and fully normal macula, then cataract removal can be considered. Probably a good idea to start steroid and non-steroid anti-inflammatory drops a week or more before the surgery to prevent macular swelling in the second eye.
onecat replied to Alan M Kozarsky, MD's response:
Yes, i was asking ''why have cataract removal in the first place if post-op correction cannot offer anything better than initial 'reading' on Snellen. Currently post op 3.5 months best is at 20/40 (same prior to surgery) but you did explain in your other post that macula swelling ( last OCT post -op was 275) could either be 'remaining' edema or from other problems and 20/40 could be the best available. However, do you feel that 3.5 months is too soon for all edema to be gone? next Snellen-reading is 2.5 months from now.
other eye currently 20/60=275 OCT .
For that eye Retina specalist mentioned pre-op injection at time of surgery ( drops prior). Thanks so much !

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