Cataract Surgery When You Also Have Retinal Disease

Cataracts and retinal disease are both common after 60, so many of our patients face both at once. The good news: having a retinal condition does not rule out cataract surgery. It simply changes the planning.

Which Problem Is Limiting Your Vision?

This is the first question to answer. A cloudy lens and a diseased macula can produce similar complaints. Careful examination plus OCT imaging usually clarifies how much of the blur comes from each. If the macula is healthy and the cataract is dense, surgery may produce a dramatic improvement. If the macula is significantly damaged, surgery will brighten and sharpen the image but cannot restore what the retina cannot detect.

Being honest about this in advance prevents disappointment afterward.

Timing Considerations

• Wet AMD or diabetic macular edema: Best to have the retina dry and stable on injections before elective cataract surgery. Surgery can reactivate swelling, and many surgeons plan an injection around the procedure.
• Epiretinal membrane or macular hole: Sometimes cataract and retinal surgery are staged; sometimes combined. Dr. Garg will coordinate directly with your cataract surgeon.
• Diabetic retinopathy: Treat active proliferative disease before surgery when possible.
• Prior vitrectomy: Cataracts progress faster after vitrectomy, and surgery is technically different — your surgeon should know your full history.

Lens Choice

Premium multifocal and extended-depth-of-focus lenses split incoming light to create multiple focal points. That works well in a healthy eye but reduces contrast — a real disadvantage when a macula is already compromised. For most patients with retinal disease, a monofocal lens delivers the best contrast and the most reliable result. Toric lenses to correct astigmatism are usually still a good option.

After Surgery

Watch for these and report them:

• New distortion or a central blank spot
• Blurring that appears weeks after an initially good result, which can indicate post-surgical macular swelling (cystoid macular edema) — treatable with drops or injections
• Any new floaters, flashes, or curtain in vision

Patients with diabetes or prior retinal disease should have a retinal check a few weeks after cataract surgery even if all seems well.

Coordinated Care

We work closely with cataract surgeons throughout Broward and Palm Beach counties to sequence procedures sensibly and share imaging. Bring your cataract surgeon's name and any recent measurements to your visit.

Questions about the right order for your eyes? Call (954) 633-8202.