For Your Good Health: Cataract Surgery Replaces Cloudy Lens For Clearer Vision | Lifestyles
DEAR DR. ROACH: When should a person have cataract surgery and can they ever be removed? I am worried because I am a 65 year old male with cataracts. Can glasses be prescribed so that I never need surgery? I ask because I know people who have had surgery and had a special lens (may I add, not covered by insurance) and did well at first and then lost their sight due to ‘inflammation behind the eye and had to use prescription eye drops for weeks. I don’t want this same problem. – Anon.
RESPONNSE: The lens of the eye, along with the cornea, bends the light entering the eye so that it is perfectly focused on the retina. The lens should be completely translucent. However, as people get older, they are likely to develop an opacity in the lens, called a cataract. (A cataract is another name for a waterfall, so called because of the foamy white appearance of an advanced cataract.) Cataract surgery replaces the opaque lens with a synthetic lens. Glasses do not specifically help with cataracts, although even a person with cataracts may need corrective lenses.
Not all cataracts require surgery: a cataract should be removed when it interferes with a person’s daily functions. There is no age limit for cataract surgery. Cataract surgery has been shown to have significant benefits, including reducing the risk of serious traffic accidents and hip fractures.
There are different types of lenses that can be put on by the ophthalmologist, the doctor who performs this type of surgery. Some of them have an increased cost to the patient compared to the “ordinary” monofocal lens. The results are generally good: 96 percent of people without eye problems before surgery had visual acuity of 20/40 or better after surgery. The rate of serious complications (hospitalization or death) is around 0.3 percent in a major journal. It looks like the person you know has had endophthalmitis, an inflammation caused by an infection, which often affects vision. This only happens about 0.04 percent of the time. Lens implants should not need to be removed.
DEAR DR. ROACH: I am due to have total knee replacement surgery and I am worried that I will have a very large hiatus hernia and when I am completely flat I can feel the hernia rise higher in my esophagus. At home, I have the head of my bed raised about 6 inches, and that helps me tremendously. For my operation, the bed will be completely flat for several hours in preparation, during surgery and during recovery. Should I be worried that there will be complications lying flat for such a long time? – JR
RESPONNSE: The diaphragm’s “hiatus” is a hole – a normal structure that allows the esophagus to pass from the chest to the abdomen so that your food can go into the stomach.
In people with the most common form of hiatus hernia, called a sliding hiatus hernia, the hole has grown large enough that the top of the stomach can move up into the chest, where it does not belong. This is often asymptomatic, but can make reflux symptoms worse. Sliding hiatus hernias (over 95% of hiatus hernias are of this type), where the stomach can move up and down through the hiatus, are not dangerous.
During the operation, the upper stomach may indeed migrate into the chest, but this is very unlikely to cause you any problems.
– Dr Roach regrets not being able to respond to individual letters, but will include them in the column whenever possible. Readers can send questions by email to [email protected] or by mail to 628 Virginia Dr., Orlando, FL 32803.