Cataract operation and RA

[Victoria-NRAS]

Hi all

I had a helpline call today from a lady who has RA and needs to have cataracts removed from both eyes. She has been informed that because she has RA she is at greater risk of complications from this surgery, and in particular something called 'corneal melt'.

I have not come across this before, and wondered if anyone on here that has RA has undergone surgery to remove cataracts? If so, I would be very grateful if you would share your experiences, in terms of the decision to have the surgery and what information you were given (and whether this risk of corneal melt or other risks due to RA were mentioned) and also the outcome of the surgery and if everything was okay.

I will check this thread periodially to see if I get some responses, but if you have feedback but for any reason do not want to post it publically on here you are welcome to send this to me by private message instead.

Many thanks

Victoria

(NRAS Helpline)

[LavendarLady]

Hi Victoria, I had cataracts removed from both eyes 3 years ago (I have had RA for 6 years). The "best" eye was done first and the "worst" done 2 weeks later. Once it had settled - about 6 weeks - I had another eye test to alter the strength of my reading glasses. I can see clearly distances but need glasses for reading but don't need them for driving. The only problem I had was earlier this year when the membrane which supports the new lens grew cloudy and I had to have laser treatment to clear it. This is apparently quite common according to my eye surgeon and 1 in 3 get this problem but it is easily fixed. The only downside is a new pair of reading glasses!

I have never heard of corneal melt and nothing of this nature was mentioned by my surgeon. I had to stop taking MTX and Enbrel for 2 weeks beforehand to avoid any infection (it is a wound although very small) and up to 2 weeks after. I suffered no ill effects and meticulously put the eye drops in each day which were given to me at the hospital. You use these for 4 weeks on a gradually reducing dose (starting off 4 times a day and reducing on the 4th week to once a day). You will then get a follow up appt about 4 weeks after the operation so the surgeon can check all is well. For the first 48 hours you are given an emergency phone number just in case of any complications arising, or the eyes swelling and becoming sore. I never had this at all.

My surgeon knew I had RA but apart from meticulous use of the eye drops and stopping the medication I had no further advice except to contact him if I was worried about anything. Cataract ops are performed thousands of times a year with usually no ill effects to anyone with existing disease problems and have a very high success rate. I believe it is over 95%. I don't think your correspondent needs to worry unduly but she might like to ask the surgeon for an explanation of "corneal melt" as I have never heard of it.

Hope this helps. LavendarLady x

[louisa480 in reply to LavendarLady]

This is my current experience. I had my surgery in 2016. Then the new lens grew cloudy. My experience was same as LavendarLady. I am currently preparing for the laser to my one eye. Very nervous. Thank you LavendarLady!

[allanah]

Sent you a pm Victoria

[Hidden]

Hi Victoria,

My experience was very similar to Lavender Lady's above - also about 3 years ago. My cataracts were caused by long-term steroids. I had a replacement lens inserted and for the first time ever now have 20:20 vision ! I now need glasses for reading as my vision was fixed for distance.

I had no adverse outcomes and my eye surgeon was fully aware of my various disease processes. I was very careful about preventing infection but just followed the instructions that I was given and used the night-time eye shield and drops as detailed by LL above.

Cece .

[Treesha]

I think the risk of corneal melt is to do with infection and overuse of steroids. I have recurring corneal ulcers and was told by ophthalmologist at the hospital that I couldn't have a repeat prescription of steroid drops due to the risk of corneal melt. Cataract extraction itself carries the risk of infection so I would assume that is why it has been mentioned x

[jaxx1 in reply to Treesha]

Hi Victoria,I have had active RA for15 years now and had a cataract op. on my left eye(the right one is not ready yet)in 2012,the surgeon was aware of my RA but it wasn't mentioned at all. the Op was brilliant, I am short sighted so the surgeon made me long sighted in the left eye and I see perfectly ( one eye long sighted,1 eye still short sighted!!) and after 40 odd years of glasses ,now don't need any.I hadn't known this was an option until he asked me which I wanted.So don't worry and go for it.Jaxx

[Treesha]

Hi just another thought. Usually corneal melts are only a problem if you have had previous cornea probs xx

[Victoria-NRAS Partner Moderator NRAS]

Hi all

Just wanted to say a big thannk you to all who posted on here or sent me PMs about their experience. This is a great help for the lady who called us and I'm sure will also be a great help to others now and in the future!

Kind regards

Victoria