Cataract Surgery - Preoperative Evaluation

Preoperative Evaluation

An eye examination or pre-operative evaluation by an eye surgeon is necessary to confirm the presence of a cataract and to determine if the patient is a suitable candidate for surgery. The patient must fulfill certain requirements such as:

• The degree of reduction of vision due, at least in large part, to the cataract should be evaluated. While the existence of other sight-threatening diseases, such as age-related macular degeneration or glaucoma, does not preclude cataract surgery, less improvement may be expected in their presence.
• The eyes should have a normal pressure, or any pre-existing glaucoma should be adequately controlled on medications. In cases of uncontrolled glaucoma, a combined cataract-glaucoma procedure (Phaco-trabeculectomy) can be planned and performed.
• The pupil should be adequately dilated using eyedrops; if pharmacologic pupil dilation is inadequate, procedures for mechanical pupillary dilatation may be needed during the surgery.
• The patients with retinal detachment may be scheduled for a combined vitreo-retinal procedure, along with PC-IOL implantation.
• In addition, it has recently been shown that patients taking tamsulosin (Flomax), a common drug for enlarged prostate, are prone to developing a surgical complication known as intraoperative floppy iris syndrome (IFIS), which must be correctly managed to avoid the complication posterior capsule rupture; however, prospective studies have shown that the risk is greatly reduced if the surgeon is informed of the patient's history with the drug beforehand, and has appropriate alternative techniques prepared.