ET, Hydroxycarbamide and cataract surgery

[Michali45]

I have to have cataract surgery, not so much because my cataracts are so bad but because I have primary angle closure glaucoma, so I don’t really have an option! I am concerned that it might take longer for my eyes (left one to be done first and right a few weeks after) to heal as I have ET. I have been advised to stop the low dose aspirin a few days before surgery but has anyone else had cataract surgery while on Hydroxycarbamide? Any comforting words, please?!

[Trueblue8]

Hi,Yes, I had cataract surgery on my right eye 5 weeks ago. I wasn't required to stop taking my medication - currently on hydroxycarbamide and low dose aspirin. The vision in my eye, following surgery, is amazing, although I wear dark glasses outside as the glare is too much!

I don't think you have anything to worry about, the surgery is both quick and painless, and after 4 weeks you should be able to resume normal activities.

Hope this helps.

Ian

[Michali45 in reply to Trueblue8]

Thanks! That is good to hear but four weeks?! Does that mean I can’t exercise, go walking, etc for that long? I have read that women shouldn’t wear any makeup for a week . I’m going to find that hard!

[Trueblue8 in reply to Michali45]

Gentle exercise is fine, so walking won't be a problem. You just won't be able to bend or lift anything heavy for 4 weeks. The benefits are amazing though, my vision is so much better now! Not sure about make up, not really my thing! 🤣 Ian

[Michali45 in reply to Trueblue8]

thanks! That is encouraging!

[Anouchka in reply to Michali45]

specifically eye makeup- mascara and eye shadow are best avoided for a food 10 days. I’ve had both done, admittedly before PV diagnosis, but the cataract surgery is a “walk in the park”. Good luck to you.

[Michali45 in reply to Anouchka]

That makes sense. Glasses will hide my ‘naked' eyes!

[Plate in reply to Michali45]

I am sure your eyes are beautiful without makeup as is the rest of your face. I go more natural now and I like it. It doesn’t matter to me what others might be thinking any longer!

[Michali45 in reply to Plate]

pure vanity on my part!

[AndyKay in reply to Michali45]

Michael I was able to do anything I wanted except lifting.

[Michali45 in reply to AndyKay]

Good! I’d feel awful if I couldn’t exercise at all but I will be careful

[hunter5582]

Having ET should not have any bearing on cataract surgery. It does not affect healing rate. Suggest you talk to your MPN Specialist about the surgery for the best advices.

[Michali45 in reply to hunter5582]

thanks, hunter. I have been in touch with my team and was just told to come off the low dose aspirin for seven days before the op.

[Mishie14]

Replacing the natural lens with an artificial lens is a fast (15 mins.) and easy procedure. No pain, no headaches, no detectable swelling and no bleeding. Most of the work was actually done by a robot! I went with premium lens vs plain lens. Insurance covered only the basic lens. I had to pay for the difference between it and the tri-focal lenses. The added cost was well worth it. No more wearing anything but sunglasses--you will need them to address glare. I did at first limit my exercise to walking our little schnauzers around the neighborhood but no limitations after just a few weeks. A year after the new lenses and having been on peginterferon since March, I can tell my distance vision has gotten worse. I am not seeing far distance as well as before. Same for me as noted by another--eye doctor testing is not identifying this change.

I was OK to go back to work the next day after each lens replacement. I did cut back on staring at a computer screen so much. I walked around the office and parking lot to let my eyes get a variety of exercise. It took about 3 weeks to feel fully recovered and comfortable with the new lenses. Starting the week of the replacement, I was taking cautionary anti-biotic via eye drops. Immediately following replacement and for 3 weeks after I continued to take the antibiotic drops and a second one for inflammation. These drops contained a steroid that had to be withdrawn from gradually.

The use of a steroid would be suspect now because of my ET. It might not change anything but steroids can impact platelets so the medical team needs to be aware. So, the anesthetic and follow up treatment drops need to be checked for any conflicts with ET and in particular for the hydroxy you are taking.

Good luck to you. I sincerely hope your experience will be as positive as mine has been. Stay safe!

[Michali45 in reply to Mishie14]

thank you! That is very helpful!

[Jamesxyz]

Hi, Just curious. Did your eye dr mention laser iridotomy as a possible treatment?

[Michali45 in reply to Jamesxyz]

no, I think the feeling was that, as I would soon need cataract treatment soon anyway, that would be the best course to take

[Jamesxyz in reply to Michali45]

Thanks for your reply.

I am being monitored for narrow angle glaucoma.

My Dr keeps mentioning the laser procedure.

Since I'm 75 and likely soon will need catarct surgery,

I asked why not just do the catarcts.

He says catarct surgery is riskier than the laser procedure.

[Michali45 in reply to Jamesxyz]

yikes!

[Jamesxyz in reply to Michali45]

I didn't mean to scare you.

Millions of people have ctaract surgery and the risk is considered very small.

I didn't agree with my Dr. But since my situation is monitor only at this point,

it wasn't worth arguing the point.

[Michali45 in reply to Jamesxyz]

that’s fine! Their point was that , as I would soon need cataract surgery anyway, it would be good to get it done now and hopefully solve the narrow angle glaucoma at the same time. I’m scheduled for the 15th July.

[Jamesxyz in reply to Michali45]

Yes, I agree completely. I'll discuss this again with my Dr.

Are you in the US?

[Michali45 in reply to Jamesxyz]

no, I’m in the UK

[AndyKay]

Michael, I had cataract surgery in both eyes about a month ago. I take hydroxy and a low dose aspirin. My surgery went very well and my eyes healed quickly. I’m amazed how much brighter and clearer everything is. I don’t know if everyone has had the same results but I’m glad I had the surgeries.

[YogaLover in reply to AndyKay]

Good to hear of your positive outcome re cataract surgery. Did you have both eyes done in the same operation or did you have to wait for a period of time between? I’m having bilateral cataract and glaucoma surgery on same day and have ET so bit anxious.

[Mishie14 in reply to YogaLover]

Can comment from my US experience and cynical perspective. I wanted both eyes done same session but the surgeon said no, that his insurance balks at it outside of an emergency situation. One appointment is common in several other countries including Canada just 15 miles from here. He said the issue is liability should something be done wrong on the first eye like if the robot has a glitch, it could be repeated on the second eye and leave the patient in a double bad state. I chose not to push the surgeon to do both eyes in one procedure. The second eye was done exactly two weeks later.

The lenses and the surgeon's cost are based on two eyes operated on regardless of one or two events. Everything else is cost based on the resources required to provide two identical but separate support services. So, separating the two procedures is nearly twice as expensive as combining them into one. Cost efficiency can be hard to quantify in the field of medicine. So much for my 40+ years in manufacturing and Six Sigma!

Best of luck on your upcoming surgeries and stay safe!

[Michali45 in reply to AndyKay]

I’m glad your surgery went well!

[YogaLover]

It seems like we are in a similar situation and I’m scheduled to have cataract and glaucoma surgery combined in both eyes at same operation in September. Will be done with general anaesthetic. I am feeling apprehensive about after care and healing. I have ET and take daily Clopidogrel and Busulfan as required.

[Michali45 in reply to YogaLover]

wow! Both at the same time? I hope all goes well!

[AndyKay in reply to Michali45]

I had the cataract in my right eye removed first, and then two weeks later, I had the cataract removed from my left eye.

[Michali45 in reply to AndyKay]

that was close! They are hoping to do my second one soon after the the first too.

[AndyKay]

I’m sure all will go well. My doctor told me he had done thousands of them. I thought it would hurt but I didn’t feel anything.

[Michali45 in reply to AndyKay]

that’s comforting, thanks!

[Doxy46]

I am 77, have ET and have been taking HU for 13 years. I had cataract surgery in November 2022 and was scheduled for the left eye shortly thereafter. I kept rescheduling the second surgery because my rt eye still bothered me. (Even 2 months post surgery,, I sometimes had to hold my hand over the eye to block all light.) It took 4-5 months before the rt eye quit bothering me. The doc said I was overly sensitive and to use artificial tears. (I am sensitive to some pollen, cats and someother things, so maybe he was right.) He also suggested antihistamine drops. The artificial tears helped the most. It is now 7 months later and the rt eye is fine, although I still have occasional dry eyes. (HU may have contributed to the dry eyes post surgery.) I'll probably do the left eye this winter, when I have more free time.

Some interesting side effects. (1) The colors I see with the rt eye are stronger. I didn't realize the cataract added a bit of yellow cast to everything. (2) Twice I could swear I saw the actual lens. The last time, a few days ago, I was resting on my side. My rt eye was a little watery. I briefly saw a series of concentric circles. By the way, my lens is for distance.

[Michali45 in reply to Doxy46]

I’m glad your eye has improved now. Good luck with the second one!