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Beside a cataract operation, is there any method?

Q: I am 67 years old and have had glaucoma for 20 years. I am still losing ground (my cup size is over 90%) and I can barely see to read. My doctor does not recommend cataract operations for my cataract because of the possibility of a pressure spike. Is there anything that can be done to improve my situation?
A: If you have glaucoma and are losing visual field , then you need surgery for the glaucoma if medications and/or laser surgery do not control the problem. If a cataract is removed as the only operation in a patient with glaucoma, particularly a patient who has uncontrolled glaucoma, a pressure spike definitely can occur. However, it is routine at the present time to do a combined cataract extraction and glaucoma operation with an adjunctive antimetabolite, such as 5-fluorouracil or mitomycin C. If you have a progressive cataract and decreasing vision and your glaucoma is not controlled, then you should certainly consider having this operation.

Can cataract surgery restore the sight I've already lost from the cataracts?

A: Modern cataract surgery, in which the cataractous, hazy lens is removed through a tiny incision (using a technique called phacoemulsification), is designed to restore vision loss due to the cataract. Following removal of the cataract, a small, plastic lens (called the intraocular lens or lens implant) is inserted into the eye to allow the eye to focus clearly once again. This lens is permanent and does not typically require replacement or reoperation. The chance of visual improvement following cataract surgery for most patients is greater than 95%. Once again, cataract surgery will reverse the vision loss due to the cataract, but not due to other diseases such as glaucoma, diabetes, or macular degeneration.

What is a nuclear cataract?

A: The lens of the eye has different structures and levels, and is organized, like an onion, in layers. A thin tissue capsule surrounds the lens. The outermost layers are called the cortex and the inner section is called the nucleus. The most common portion of the lens to become hazy is the nucleus, and this is termed a nuclear cataract. Other people develop cortical cataracts.


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