There鈥檚 no such thing as surprise-free or risk-free surgery. To get an update about cataract surgery, I interviewed Dr. Raymond Stein, medical director of the Bochner Eye Institute, and associate professor of Ophthalmology at the University of Toronto.
Today, half of North Americans have developed cataracts by age 80. The only good treatment when visual loss finally affects quality of life is to have a foggy lens removed and replaced with another one. Today, due to improved surgical advances, it鈥檚 possibly the safest surgery performed.
But I also receive reports from people who are not pleased with their altered vision. Some wish the cataract surgery had never been done. So I asked Stein what can go wrong, so patients won鈥檛 have surprises.
Stein says that infection is always a concern. But now eye incisions are only a few millimeters long, so infections are rare.
Fortunately, when they occur, the majority can be treated with antibiotics. But on rare occasions, an eye is lost.
That鈥檚 why one should always remember this fact of life. There may be only one chance in thousands of losing an eye, but if the gods say it鈥檚 going to happen to you, it becomes a 100 per cent hit.
You might conclude that it would have been prudent to delay surgery. But delaying surgery is also risky. Foggy vision can result in falling, fractured hips and death.
Stein says that retinal detachment is another serious complication. Luckily, it鈥檚 also a rare one.
The retina, the back part of the eye, transmits images to the brain.
So if the retina becomes detached, vision is impaired and it can lead to blindness. If this complication happens, the retina can be re-attached by gas injection, laser therapy or by other intraocular surgery.
Stein lists yet another complication: displacement of the lens.
The new lens is normally held in place by what鈥檚 called the posterior capsule. But just as joints can become dislocated, so can the lens. This might happen many months later and require another operation.
Sometimes these problems are an act of God and could not have been prevented.
But as I鈥檝e stressed for years, it鈥檚 prudent to always go to surgery with a first-class ticket.
Why? Because it鈥檚 been aptly said that 鈥減ractice makes perfect.鈥� This is true whether you鈥檙e a plumber or a cataract surgeon.
So I asked Stein how many cataract operations he had performed. His answer? 50,000 over the past 30 years. That鈥檚 a lot of practice.
You say that, as a lay person, it鈥檚 easier said than done to find a first-class surgeon.
I agree it鈥檚 never easy. But here鈥檚 a medical tip: If you鈥檙e fortunate enough to know a scrub nurse who hands doctors instruments day after day, ask her. You will never find a more reliable source.
Since prevention of cataracts is better than cure, wear sunglasses to decrease the effects of sunlight. Living close to the equator increases risk of cataracts. So does high altitude.
The people of Tibet have the highest rates of cataracts in the world. And be sure to use protective glasses for tennis and other sports.
What about the use of vitamins? The cornea and lens have the highest concentration of vitamin C in the body.
In one study, those with low levels of C had 11 times greater risk of developing a cataract. So for years, I鈥檝e taken daily high doses of vitamin C powder, partly for eye protection.
During the interview, Stein mentioned a very interesting point. He said patients at the Bochner Eye Institute are offered a choice of either the traditional cataract operation or the new laser surgery.
I asked him the logical question: 鈥淲hat type would you choose?鈥� His quick reply: 鈥淟aser surgery.鈥� He added: 鈥淚鈥檝e also used the laser procedure on the past 25 ophthalmologists.鈥�
I quickly concluded that what鈥檚 best for ophthalmologists is also good for the rest of us. That鈥檚 medical tip No. 2.
