Iritis and Cataract surgery

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ajaivyas
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Joined: Wed Oct 31, 2007 11:57 am

Iritis and Cataract surgery

Post by ajaivyas »

My mother-in-law has iritis and has been developing catarct also. She is 60 years of age and has diabetes. Doctor suggested surgery to remove cataract, and to do it fast. Will removing cataract help her iritis or future chances of retinopathy? Is cataract operation dangerous for a diabetic with iritis?

Thank you so much,
Ajai
Mike Bartolatz
Posts: 6595
Joined: Fri Feb 06, 2004 9:58 pm

Post by Mike Bartolatz »

Cataract surgery in anyone with active iritis can be a problem causing inflammation that can be extremely difficult to control. the degree to which one has lost significant vision determines the timing of surgery even more so than the 'normal' cataract patient who has never had uveitis of any form.. I don't know if there have been any longitudinal studies related to cataract surgery in a diabetic with uvieits. I am however a diabetic who had cataract surgery which caused inflammation that took over a year to quell for each eye. I would do it again as my vision was 20/200 in each eye prior to surgery, that way should I end up losing the eye it wouldn't make too much difference. I am considered to be blind in my left eye today with vision corrected to 20/40 in my right eye with glacoma causing the damage. I have epiretinal membranes and enlarged blind spot in my right eye along with recurrent cystoid macular edema in it as well with some peripheral vision loss. the epiretinal membranes are directly over my maculas causing blur and flutter of vision.

my brother went blind from vascularization of the retina linked to type II diabetes. so, being a diabetic myself I can empathize with you and your mom. you might consider a visit to a uveitis specialist for consultation prior to surgery as an Uveitis specialist will have allot of experience with Cataract surgery with the iritis patient and will know when Intra Ocular lenses are appropriate for her as well as know how to manage inflammation prior to and after the surgery. if you will tell me where you live, it can suggest the closest specialist for a consultation. she will most likely have to travel as these are very rare specialists

the key is to have a surgeon VERY EXPERIENCED in management of uveitic cataracts so that precautions can be taken at time of surgery to prevent a major flare up of uveitis; but, it still might occur even with the very best doing the operation. thereis absolutely no way of knowing who will have a terrible time of it

Wish her the very best for me please,
Mike
Mike Bartolatz
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ajaivyas
Posts: 2
Joined: Wed Oct 31, 2007 11:57 am

Post by ajaivyas »

Thank you so much, Mike. Your reply was very helpful.

Her cataract is not really bad. My impression was that she should wait till cataract becomes a limiting factor for her vision. For some reasons, her doctor in India insists on surgery right now. I am more inclined to wait till cataract is more mature, because I do not want to take unnecessary chances with inflammation right away. Am I missing something, for which her doctor would want surgery now, even if cataract has not become a big problem?

I have tried to talk to her doctor, but have not been offered a good answer.
Mike Bartolatz
Posts: 6595
Joined: Fri Feb 06, 2004 9:58 pm

Post by Mike Bartolatz »

For some MONEY is the guiding factor. there is a VERY good Ocular immunologist in India, if you can afford to get her to see her that would be my suggestion as a second opinion by a TRUE expert in the diagnosis and treatment of Uveitis might prove very beneficial in the long term outcome for her vision as a corticosteroid sparing approach may well be indicated. the steroids alone used to treat iritis WILL cause cataracts, glaucoma, etc over time by themselves. not good for tissue already being bombarded by too much glucose from being a diabetic.

If you would like, I'll go to the international Specialist list and get the contact information for the EXPERT in the diagnosis and treament of uveitis in India. if cataract surgery is needed this is who I would suggest do it anyway.

Wish your mom the very best,
Mike Bartolatz
Mike Bartolatz
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Mike Bartolatz
Posts: 6595
Joined: Fri Feb 06, 2004 9:58 pm

Post by Mike Bartolatz »

Rajesh Babu M.D.
Dept of Uveitis & Ocular Immunology
Lead Medical informatics & EMR
Narayana Nethralaya , Narayana Health City Hosur road, Anekal Taluk,
Bangalore - 562158, INDIA
Ph : +91-80-66660655-0657
Mobile +91 9844559214
Email : ruveitis@gmail.com

Jyotirmay Biswas, MD
Medical Research Foundation Tel: 91-44-8271616
18 College Road FAX: 91-44-8254180
Madras 60006
E-mail: drjb@sankaranethralaya.org

Dipankar Das, MD, MS
Associate Consultant
Department Of Ocular Pathology and Uveitis services Sri Sankaradeva
Nethralaya Guwahati, Assam, INDIA Pin Code- 781028
Phone-91-0361-2228879/80
Fax-91-0361-2228878

Amod Gupta MD
Department of Ophthalmology
Tel: 91-172-2747837 FAX: 91-172-2747837
Postgraduate Institute of Medical Education & Research
Chandigarh, 160012
INDIA
E-mail: eyepgi@sifi.com

Kannan M Narayana, MBBS, DOMS, DNB
Fellowship In Uveitis and Ocular Inflammation
Team Lead, Research and Planning
Narayana Nethralaya, Bangalore
website
TEL: 0091-80-23373311, 23576855

S.R. Rathinam, MD
Head of Uveitis Service Tel: 0452-532653
Aravind Eye Hospital FAX: 91-0452-530984
PG Institute of Ophthalmology
1 Anna Nagar
Madurai 625 020
E-mail: rathinam@aravind.org

Virender Sangwan, MS
L.V. Prasad Eye Institute
Road #2, Banjara Hills
Hyderabad (AP) 500 034
Tel: 91-40-248267 Fax: 91-40-248271
E-mail: Vsangwan@lvpeye
Mike Bartolatz
Moderator
Mike Bartolatz
Posts: 6595
Joined: Fri Feb 06, 2004 9:58 pm

Post by Mike Bartolatz »

Below you will find contact information for the BEST Opthalmologists in India, those who have done a FELLOWSHIP in Uveitis have the best training, those who are in Uveitis and Ocular Immunology departments are good bets as well.
the last doctor on the list has done extensive researh in Uveitis publishing many papers on the topic and who is very good as well.

Wish your mom the very best,
Mike

Rajesh Babu M.D.
Dept of Uveitis & Ocular Immunology
Lead Medical informatics & EMR
Narayana Nethralaya , Narayana Health City Hosur road, Anekal Taluk,
Bangalore - 562158, INDIA
Ph : +91-80-66660655-0657
Mobile +91 9844559214
Email : ruveitis@gmail.com

Jyotirmay Biswas, MD
Medical Research Foundation Tel: 91-44-8271616
18 College Road FAX: 91-44-8254180
Madras 60006
E-mail: drjb@sankaranethralaya.org
Dipankar Das, MD, MS
Associate Consultant
Department Of Ocular Pathology and Uveitis services Sri Sankaradeva
Nethralaya Guwahati, Assam, INDIA Pin Code- 781028
Phone-91-0361-2228879/80
Fax-91-0361-2228878

Amod Gupta MD
Department of Ophthalmology
Tel: 91-172-2747837 FAX: 91-172-2747837
Postgraduate Institute of Medical Education & Research
Chandigarh, 160012
INDIA
E-mail: eyepgi@sifi.com

Kannan M Narayana, MBBS, DOMS, DNB
Fellowship In Uveitis and Ocular Inflammation
Team Lead, Research and Planning
Narayana Nethralaya, Bangalore
website
TEL: 0091-80-23373311, 23576855

S.R. Rathinam, MD
Head of Uveitis Service Tel: 0452-532653
Aravind Eye Hospital FAX: 91-0452-530984
PG Institute of Ophthalmology
1 Anna Nagar
Madurai 625 020
E-mail: rathinam@aravind.org

Virender Sangwan, MS
L.V. Prasad Eye Institute
Road #2, Banjara Hills
Hyderabad (AP) 500 034
Tel: 91-40-248267 Fax: 91-40-248271
E-mail: Vsangwan@lvpeye
Mike Bartolatz
Moderator
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