CATARACT 8 EWAP MARCH 2024 Before deciding to move forward with cataract surgery, there are a variety of factors that surgeons must consider. Several physicians discussed the timing of the surgery and how they counsel patients about this. Mitra Nejad, MD, said it’s less about how advanced the cataract is on the exam and more about the patient’s description of how they are bothered by their vision. Dr. Nejad has a mix of patients, including referrals from colleagues, so she often sees more visually significant cataracts that are ready for surgery. “On the other hand, I’ll get some self-referrals or primary care physician referrals for evaluation of cataract, and I often schedule those alongside an optometrist who I work closely with, in case all they need is an updated glasses prescription,” she said. When getting referrals from retina colleagues, Dr. Nejad said these might need to be operated on more quickly because the cataract is impairing the Contact information Kandavel: valleyeyedoctor@gmail.com Nejad: mnejad@mednet.ucla.edu Rai: amandeepraimd@gmail.com Considerations for proceeding with cataract surgery by Ellen Stodola Editorial Co - Director physician’s ability to provide treatment for the retina pathology. Dr. Nejad said it’s rare that the cataract surgery must happen urgently. However, she noted that some patients come in having failed a driving test, and she wants to address these patients as soon as possible to get them back to functional status. “Otherwise, I usually tell the patient, ‘The cataract is significant, I think you should consider surgery, but the good news is there’s nothing urgent about it, and you can schedule the surgery at your convenience.’” If the cataract is mild and the patient isn’t eager to do surgery, Dr. Nejad will ask the patient to come back in a year. If the cataract is dense and the patient isn’t eager to have surgery, she’ll have them return sooner. Dr. Nejad has noticed that because patients are hearing good things from family and friends about refractive cataract surgery, this decreases their overall anxiety about eye surgery. Dr. Nejad noted that she has seen a wave of worse pathology with the COVID-19 pandemic because patients have gotten used to a lifestyle with less driving and more time at home. Patients weren’t coming in for elective procedures and weren’t noticing visual impairment as much until they had to go out Dr. Kandavel tries to establish a strong personal connection with patients over years of appointments or even in one meaningful consultation. “Trust is the key to patients following your surgical recommendations,” he said. Source: Rom Kandavel, MD This article originally appeared in the December 2023 issue of EyeWorld. It has been slightly modified and appears here with permission from the ASCRS Ophthalmic Services Corp.
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