Retinal lattice degeneration6/3/2023 ![]() Devgan, patients who have their diabetes under control and who have minimal background diabetic retinopathy without macular lesions tend to do very well with cataract surgery. She recommends obtaining an OCT for all patients prior to cataract surgery.Īccording to Dr. However, in patients with a recent history of or active DME, she likes to see them in the perioperative period to ensure that their retinal status is optimized before they go to the OR and that they do not require retinal treatment afterward. ![]() Weng said that if a patient has no history of DME, she does not specifically ask to see these patients preoperatively (assuming that an OCT has been obtained by the cataract surgeon) or postoperatively unless they are experiencing visual symptoms. “Remember that it can also be difficult to discern whether postoperative macular edema is truly an exacerbation of DME versus Irvine-Gass syndrome a fluorescein angiogram can be helpful in these situations,” she said.Īdditionally, Dr. The literature is mixed when it comes to the possibility of cataract surgery inducing DME, 1,2 but this association is less apparent in more recent studies that employ modern phacoemulsification techniques and technology, Dr. Weng said historically, there was a concern that inflammation from cataract surgery could induce cytokine release and breakdown of the blood-retinal barrier that could theoretically worsen diabetic macular edema (DME). “Additionally, it gives you the opportunity to counsel the patient about the low risk of retinal detachment associated with cataract surgery and to review return precautions with them the latter is crucial since cataract surgery often induces a postoperative PVD.”Ī 68-year-old patient with dry AMD (bottom) had a single-piece acrylic monofocal IOL placed in the capsular bag (top) during cataract surgery.ĭr. “I prefer this timeframe because it is close enough to the surgery date that developing new pathology prior to the cataract extraction is less likely, but if any pathology is found, it potentially (although not always) could be treated without having to reschedule the surgery,” she said. She prefers to perform a dilated retinal examination approximately 1 month prior to planned cataract surgery for anyone with a history of high myopia or peripheral retinal issues, such as an old tear or lattice degeneration. “These high-risk patients are referred to our vitreoretinal colleagues for evaluation prior to cataract surgery.”Ĭhristina Weng, MD, said that the exact timing for the exam will differ from provider to provider. “There are higher risk patients such as those with axial myopia, previous retinal issues like breaks or detachments, retinal vascular disease, and macular issues like epiretinal membrane and diabetic macular edema,” he said. Uday Devgan, MD, said that he will check the retinas of all patients who are having cataract surgery. He said this check is very important for patients who are myopes, those with previous tears or retinal detachment, but it should be done on all patients. Charles said that it’s important to do a preop dilated peripheral retinal examination with an indirect ophthalmoscope to determine if there are retinal tears, holes, lattice, and areas of weakness. Mohsenin can help you determine which treatment is best for you.A 75-year-old patient developed a posterior vitreous detachment 3 weeks after uncomplicated cataract surgery in his right eye.ĭr. In certain circumstances, we may perform preventive laser therapy or cryotherapy (a type of freezing treatment) to strengthen the peripheral retina in the areas where it is weak. Generally, no treatment is needed for lattice degeneration aside from regular monitoring with a dilated comprehensive eye exam. Lattice degeneration is minimally progressive, and the vast majority of patients with this condition never develop a retinal tear or detachment. Retinal tears and retinal detachments are very serious conditions that require prompt attention from an ophthalmologist or retina specialist. However, in rare cases, it can lead to a retinal tear or detachment. Lattice degeneration itself does not cause symptoms. What are the Symptoms of Lattice Degeneration? For this reason, once diagnosed, lattice degeneration should be closely monitored. The presence of lattice degeneration, which is abnormal thinning of the peripheral retina, increases the risk of retinal tears and detachment.
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