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Retinitis pigmentosa: is cataract surgery more risky?

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Retinitis pigmentosa: is cataract surgery more risky?

Cataracts are one of the most widespread eye diseases in the world and represent one of the main causes of reversible blindness. It occurs when the lens, which is naturally transparent, loses its clarity, becoming cloudy and thus limiting the ability to see clearly. The World Health Organization estimates that approximately 18 million people worldwide are blind due to cataracts, making surgery to remove them a vital procedure.

Cataract: how to understand when it is time to have the operation and what results to expect by Irma D’Aria 04 March 2024

Every year in Italy approximately 650,000 cataract operations are performed. Although cataract surgery is one of the most common and generally safe, it is not without risks. Complications can include infection, bleeding, retinal detachment, or even vision loss, although such adverse events are rare with modern surgical technologies.

This is why careful pre-operative evaluation and rigorous post-operative follow-up are essential to minimize risks and ensure the best possible results for the patient. The reader who writes suffers from retinitis pigmentosa and asks to know if the risks he faced could have been avoided. He replies Stanislao Rizzodirector of the Ophthalmology Unit of the A. Gemelli Irccs University Hospital and full professor of Ophthalmology at the Catholic University of Rome.

Request. Dear doctor, at the age of 58, due to a cataract still in its initial stage on an eye affected by retinitis pigmentosa, the surgeon decided to perform the operation. At the follow-up visit three days later, it was found that an infection had irreversibly destroyed the optic nerve resulting in total loss of vision. In these very particular cases like mine, is it necessary to have specific precautions and attention or can we follow (as done) the ordinary routine? Thank you

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Answer. The retinitis pigmentosa it is a pathology that affects over a million people worldwide and, in addition to being associated with alterations of the fundus of the eye, a reduction in the visual field and night blindness, it can lead to a greater incidence of subcapsular cataract in patients even young. However, cataract surgery is not without risks. Among the main ones complications there are ocular hypertonicity, ocular surface disorders, macular edema, retinal detachment and ocular infections, better known as endophthalmitis. Cataract surgery represents 90% of the causes of endophthalmitis and can be classified into three different forms: the immediate acute (or fulminant) form which occurs within 2-4 days of the surgical procedure; the acute (delayed) form after 5-7 days after the operation, the chronic form with presentation no earlier than one month after the operation. The treatment consists of the injection of antibiotic drugs, if possible vitrectomy, at the same time as carrying out vitreous samples to understand the responsible pathogen. Recovery of vision following surgery depends on the severity of the infection and the pre-existing general condition of the eye. Once the bulb has assumed a state of rest after surgery it can return to leading a normal life. In your case you could consider being followed at a specialist low vision centre, where you can better evaluate your visual-functional residual.

Retinitis pigmentosa: how to understand if your children have inherited the disease by Irma D’Aria 13 December 2023

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