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Cataract

Best Pediatric Ophthalmologist

QUESTION:

Could you please let me know, do you perform cataract surgery for children? Currently I am searching for the best surgeon for my daughter, 5 years old…

******


ANSWER:

Dear ******,

Although I do not perform surgery on children, I can highly recommend Dr. Jonathan Song who practices in both Baltimore, MD and Los Angeles, CA.  If my own six year old daughter were to need eye surgery I would not hesitate to have Dr. Song operate on her.  You can find out more about him here: http://www.keckmedicine.org/doctor/jonathan-c-song/

 

Warm regards,
David Richardson, MD

Date: May 5, 2014

 

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Would a Patient Benefit from Cataract Surgery If a Patient Has Both a Macular and a Cataract?

ANSWER:

If the cataract is significant then vision often improves after cataract surgery even with a mild macular pucker.  That being said, if the pucker is significant the vision will still be limited by the retinal distortion.

Swelling of the macula (termed “macular edema”) is more likely after cataract surgery when a macular pucker is present.  This swelling is generally treated with drops, injections, or even surgery.

If the vision after cataract surgery is significantly limited by the macular pucker then another surgery called Pars-Plana Vitrectomy with Membrane Peeling (PPV/MP) is generally performed.

PPV/MP is technically less challenging for the surgeon after the cataract has first been removed.  Because of this, cataract surgery is often recommended prior to PPV/MP even when it is expected that the vision will be limited by the macular pucker.

Alternatively, if PPV/MP is performed first, then the cataract tends to rapidly progress often requiring cataract surgery within a matter of months.

 

Warm regards,
David Richardson, MD

Date:  Jul 5, 2013

 

Permalink.

Cataract Surgery and Canaloplasty

QUESTION:

Dear Dr. Richardson,

I need to maintain IOP of around 14 which I have with drops currently. Is Canaloplasty still an option for me? I am due for cataract surgery and I am very interested in Canaloplasty.

Thanks,

******


ANSWER:

Dear Mon, Feb 16, 2015 at 8:13 AM,

It is possible for Canaloplasty combined with cataract surgery to achieve IOP lowering into the low teens. I even have a handful of patients who have had both cataract surgery and Canaloplasty who now have IOPs below 10mmHg (though I would not expect that). As with all surgeries, Canaloplasty does not work in everyone and a small percentage fail over time. That being said, I will often recommend Canaloplasty over trabeculectomy (“trab”) or glaucoma drainage devices (“tubes”) as Canaloplasty is safer and even if it fails it is still possible to have a “trab or tube”. Once a trab or tube is done, however, Canaloplasty is more challenging to perform (if at all possible) and is more likely to fail than if Canaloplasty had been done before the trab or tube.

Warm regards,
David Richardson, MD

Date: Mon, Feb 16, 2015 at 8:13 AM

 

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