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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10884
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Hi. Dr. Rick. Me again. I did decide to go ahead with the cataract

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Hi. Dr. Rick. Me again. I did decide to go ahead with the cataract (thanks for the encouragement), exchanged emails with retina doc yesterday, and will do my consults soon. Ques: my Rx is -6.00, -050, 95. I was thinking of just a 'plain' IOL and continue to wear glasses. I am sure that surgeon will discuss this with me, however, is that one of the IOL choices ... to just put in a IOL that acts like a regular one w/o any Rx ?? Any other pearls of wisdon/advice?? You have been very helpful, FYI :)

Dr. Rick :

Hi. My name isXXXXX and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.

Customer:

Good morning

Dr. Rick :

I would go with the "plain" (monofocal) IOL. It has been around for decades and worked trouble free for millions of patients......

Dr. Rick :

The mulitfocal IOLs also work well, but if you don't mind wearing a thin pair of glasses, why tempt the fates and mess with the fancy lens?

Customer:

I concur, and my other eye has correction of -300 without a cataract so I would need glasses anyway. Due to the fact that I have a buckle and have had a whole bunch of srgon laser treatments in the past, am I at higher risk for a RD, or higher risk than the general population of any complication, or jsut regular risk??

Dr. Rick :

At this point,so far out from you SB and retina surgery, I would say you are at the same risk as the general population....maybe even a bit less since your retina should be pretty well "welded" down in place :)

Dr. Rick :

PS: I'm glad I've been of help before :)

Customer:

Nice. My other eye had macula retinal bleeding (before the injections) so I had laser centrally which destroyed central vision to that eye. But this 'cataract eye' never had such. Would an injection of avastin or lucentis prophylactically still be worth the reward over risk, in your opinion?

Customer:

You have been of MUCH help. My own virtual doc !!

Dr. Rick :

lol!

Customer:

So, do you recommend prophylactic injection ?

Dr. Rick :

Are you talking antibiotics at the end of the surgery?

Customer:

I have not yet met with catract surgeon, but I assume (bad word?) that antibiotics will be prescrivbed. I am referring to the antyi-VEGF injection

Dr. Rick :

No. There are no oral antibiotic given after cataract surgery.

Dr. Rick :

As far as the VEGF injection.....that is a very controversial issue in the ophthalmology world right now......

Customer:

OK- I'll leave it to my trusted retina doc

Dr. Rick :

That was exactly what I was in the middle of typing :)

Customer:

We're old buddies by now

Dr. Rick :

Since he knows you the best he is in the best position to advise you on this sticky issue.

Customer:

Ah ! A Minnesota politician . I love it !!

Dr. Rick :

I, personally, have nothing against using avastin, etc, in very selected cases....so, as you say, go with his recommendations.

Dr. Rick :

:)

Customer:

Again (and maybe not the last time) I greatly thank you !!

Dr. Rick :

Let me know how things go after your surgery

Dr. Rick :

My pleasure. Have a good weekend.

Dr. Rick :

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

Customer:

You too, my friend.

Dr. Rick :

Thanks.

Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 3 years ago.


Follow Up. I saw retina doc today, who said that no VEGF injection is needed. He did say, however, that because of previous SB and CSR hx, that there is a greater chance of another RD for me than general pop and also inc chance of macula edema. He guessed that to be another 4 or 5 %. I have an appt with cataract surgeon in 3 weeks. And, of course, he left decision to me, but at 20/400 now and 20/200 before cataract 5 years ago, seems right way to go as cataract is progressing. Any thoughts on the inc risk of RD? Thanks for everything! [Reminder - other eye has no central vision but 20/200 distance due to laser post macula bleed in 2000]. .

Rich,

Your retina doc knows your eye best and I agree: 5% is about right for an increased risk of a new RD or macular edema.

With the decreased vision you have experienced I would say that the benefits of the cataract surgery are enough to warrant going ahead.

I am sure your cataract surgeon and retina doc will be watching extra carefully for any possible complications and will jump right on them should any occur.

So. What is the take home message? Good luck on your cataract surgery :-)

Let me know how things turn out....
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