published Thursday, October 10th, 2013

Ask a doctor: Need advice on worsening eye condition, diabetes

Dr. Steven M. Thomas

Q: I had successful RK surgery and LASIK surgery. I also have well-controlled diabetes. Now, my vision is worsening, and I wear bifocals. I have developed cataracts, but doctors differ on whether I can have cataract surgery after the earlier surgeries. I am confused and concerned.

— Terry B. Moore, Varnell, Ga.

A: Radial Keratotomy and LASIK are both refractive surgeries on the cornea (surface of the eye). Bifocals are not uncommon around the age of 40. Metformin or any medicine for diabetes decreases but does not eliminate the potential for retina (back of the eye, "film in the camera") problems such as blurred vision. The natural lens in the front of the eye (behind the pupil) can develop cataracts which blur vision. With any corneal surgery, much less two, calculating the post-operative glasses with an intraocular lens implant becomes more difficult. Before any surgery, the diabetes needs to be under excellent control. When the cataract causes enough blurred vision to prevent vision for the activities of daily living, then surgery is appropriate. At that time, your surgeon can discuss the lens implant options and the success rate of choosing best vision for distance versus near. As with any surgery, cataract surgery is a very important option and, fortunately, one with excellent success.

— Dr. Steven M. Thomas, ophthalmologist; member, Chattanooga-Hamilton County Medical Society

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