Cataract Removal for People with Retinal Degenerative Diseases - A Q&A with two Foundation-funded clinicians

May 05, 2013
To help people with retinal degenerative diseases better understand issues related to cataracts and their removal, Foundation-funded clinicians Richard Weleber, M.D., of the Casey Eye Institute, Oregon Health & Science University, and Jacque Duncan, M.D., of the University of California, San Francisco, provide the following answers to commonly asked questions:


  1. Why do people with retinal degenerative diseases get cataracts more frequently than the general population?
    Researchers don’t know for certain, but they believe that more frequent cataract formation occurs because degenerating photoreceptors cause chronic, low-level inflammation in the eye. The cataracts are somewhat similar to the type that patients with uveitis get. (Uveitis is swelling and irritation of the uvea, the middle layer of the eye.)
  2. What are the hazards of cataract removal, especially for someone with a retinal degenerative disease?
    People with retinal degenerative diseases have increased risk of complications from cataract removal, because of the fragility of their retinas. Some complications include: inflammation of different parts of the eye, macular edema (swelling of central retina), and more difficult management of an existing epiretinal membrane (scar tissue).
  3. How does one reduce their risk of complications?
    The surgery should be performed by someone expert at removing cataracts, using as little light as possible and practical. The patient should be treated aggressively for ocular inflammation before and after surgery. Ideally, the surgeon should be familiar with retinal degenerative diseases, and the special considerations that need to be made when performing surgery on these patients.
  4. Does the type or extent of retinal disease impact the decision to have a cataract removed?
    Yes. The extent and location of damage to the retina will certainly affect the decision process. The physician(s) will consider the odds that vision will be improved following the surgery, and whether the benefits of surgery outweigh the risks. All people with retinal degenerative diseases should thoroughly discuss the potential risks and benefits of cataract removal with their ophthalmologist.