Cataract surgery with history of OCULAR HSV

[rh52]

I am a 66 year old male. Three years ago, I had an outbreak of hsv in my left eye. I had never even heard of such a thing until it happened to me. Two years later, the same eye became very blurry, seemingly overnight. I suspected it had something to do with the hsv. I had it checked at the same practice where I was treated for the virus. Their diagnosis was a cataract. I wasn't totally convinced, as my eye also felt irritated much of the time. I subsequently got a second and third opinion. Both diagnosed cataract. I have started the process of moving forward with cataract surgery. I have been scheduled for surgery in two weeks. After stumbling onto this forum and reading through many posts, I now feel I should stop everything and do more research. I am not confident in the type of iol I chose (multifocal). More importantly, I'm not confident in the surgeon. He seems to have completely ignored the possibility of major complications due to the previous HSP infection. He has prescribed 3 different eye drops to use before and after surgery, but nothing to prevent another HSV outbreak, post surgery. I feel perhaps I have become tangled up with an assembly line style surgery center. Any thoughts would be appreciated.

[JohnHaganMD]

I would see another surgeon.  With a history of herpes simplex virus on the eye most surgeons would start an antiviral pre-operatively like acyclovir/famvir/valtrex and continue through the healing process.  Steroid drops would be used with caution as that can cause a flare-up.  Even if this wasn't a problem not having confidence in your surgeon BEFORE surgery is a deal breaker. You want to go under the knife believing in the skill, integrity and compassion of your surgeon.

[rh52]

Thank you so much for your reply. I have read many of your posts, but have barely scratched the surface, I'm sure. You have contributed a great wealth of knowledge, insight, and wisdom. You are an amazing man and a humanitarian in the truest sense.
I chose the surgeon after reading rave reviews about him on the internet. I believe he is very skilled and also has a nice polite manner. However, I did feel some pressure to upgrade to an expensive iol. That, combined with what I perceive to be an oversight regarding the HSV,  has given me cause to hesitate. If you know of a fine surgeon in the Las Vegas area, I would greatly appreciate the info. Thank you, again.

[JohnHaganMD]

I'm sorry I do not know an surgeons in that area.  I have posted here many times and many offices are totally invested in upselling. From the moment you enter the door you are first lead to believe :  1 You need cataract surgery . Not every office is that way but many will operate on anyone and everyone regardless of how tiny the cataract is.  In my Kansas City practice we have a very very agressive surgeon and virtually everyone over 60 is told they have a cataract and need surgery.  Most of my consults end up you barely have a cataract and you don't need surgery until you a really unhappy with your visual functioning.  2. They are told many places a standard aspheric monofocal  IOL is inferior.   They push multifocal IOLS with guarentees the person will not need glasses. Most do, many are unhappy with night vision.   3. they push femtosecond laser, ORA technology.   I saw a person that had spent $12,000 out of pocket with what they said was a guarantee they would not need glasses. They did need glasses for some things and they were very unhappy with their night vision.    If you feel you are being pressured to spend a lot of out of the pocket money get a second or third consult. As I have posted my wife had cataract surgery and we chose and she is very happy with a standard aspheric monofocal IOL.

[rh52]

My LE definitely has a problem. I am very skeptical of their claim that my RE also has a cataract that is "ready". I feel my RE has very good corrected vision. I fully understand why they have the incentive to tell you something that isn't entirely true. What idiot would spend $2000 to $4000 out of pocket for a multifocal iol for only one eye?

[JohnHaganMD]

You probably won't but there is a fool born every minute.  For elective surgery don't let yourself be pressured by the surgeon or her/his staff. Many of the staff work on commission.