• Can I have surgery done under general anesthesia?


    Question:

    I'm a 55-year-old old male with extreme light sensitivity and a severe case of ommatophobia (fear of eyes). Treatments could not help me get rid of this psychological disorder. I had a cataract surgery under general anesthesia two years ago and now I have a secondary cataract. I'm trying to find a doctor to perform a YAG laser capsulotomy surgery under general anesthesia. Is that possible?


    Answer:

    YAG laser capsulotomy is the internationally accepted and preferred treatment for secondary cataract (also known as posterior capsular opacification), or a clouding of the capsule that held your eye’s natural lens in place). This treatment requires the patient to look at a given point and not to move their eyes as each laser pulse is delivered, so you cannot be asleep during the procedure. In many cases the entire treatment can be accomplished with one or two laser pulses. It is much safer than the bladed surgery used before YAG that I know of no doctor that would not advise YAG laser for capsulotomy. There is no pain whatsoever.

    Before YAG laser treatment was done, secondary cataracts were surgically treated with a special needle/knife in the operating room. In fact, general anesthesia is still used for this needle/knife procedure in children. The surgical risks are still very low, but definitely higher than YAG. If you are completely certain that hypnosis and tranquilizing medications would not make it possible for you to have YAG, then I would advise you to discuss this surgical approach to your problem with your ophthalmologist. He/she might refer you to a pediatric ophthalmologist as they would likely have more experience performing the bladed capsulotomy.

    There are a few pediatric ophthalmologists around the country that do have a YAG laser that can be used under general anesthesia, however, most are located in a children's hospital. I would suggest you make some inquiries in your area to see if this exists. Otherwise, you could seek out the care of a retina specialist that might approach this from behind the implant.

    You may have another problem however: an insurance problem. I suspect that you, your ophthalmologist and a qualified psychologist/psychiatrist would need to convince your insurance company why they need to pay the added expense of an operating room, anesthesia, and other related expenses when such a simple and cost-effective laser treatment can solve your medical problem.


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