• I need both Macular Hole Surgery and Cataract Surgery. Which surgery should be done first?


    Question:

    I have a hole in my macula and macular degeneration. My cataract surgeon says the cataract has to be removed first. The retinal doctor says he can do the hole repair first. What should I do? The cataract surgeon says he can't put in an implant if the hole is repaired first.


    Answer:

    This is not an unusual situation, and it is managed differently by excellent ophthalmologists. However, it is not true that cataract surgery with an implant cannot be performed after macular hole surgery. If the cataract does not interfere with surgery for the hole, it can be performed first. Alternatively, the cataract surgery can be performed initially. There appears to be growing enthusiasm for doing both procedures at the same time. This may require a "tag-team" approach in which the vitreoretinal surgeon prefers to have a "cataract specialist" perform that step. Perhaps an independent third opinion might be in order.


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