Cataract Surgery for Patients with Autoimmune Disorders: What to Expect

Anyone living with an autoimmune condition knows that it can have far-reaching implications. This includes how it affects the health of your eyes. So, if you’ve had the, “It’s time for surgery” conversation with your ophthalmologist, it can be a scary time. 

But, cataract surgery and autoimmune disorders aren’t necessarily an equation for potential problems. Indeed, it’s well-proven that patients with non-ocular autoimmune diseases are not at a higher risk of post-surgery complications.

OK, so that’s great. But what if your condition does affect your eyes? Perhaps you’re a Type 1 diabetic, have MS, lupus, or suffer from rheumatoid arthritis. Well, while this does increase potential surgical risks, there are plenty of steps that your surgeon can take to reduce these.

Some of the special considerations for cataract surgery in such cases include:

• Careful treatment of the underlying condition and getting symptoms under control before commencing surgery: This may well involve your cataract surgeon working in conjunction with your autoimmune specialist. Ensuring that your eyes are stable and in the best possible condition before surgery is crucial, so don’t be surprised if your specialists decide on a few management tweaks to get you best prepared. 
• Understanding your unique eye geography: No one else has eyes like yours. Many  autoimmune conditions affect the eye, such as long-term steroid use, blood sugar fluctuations, chronic dry eye, current or previous uveitis, and many of the medications used to treat the disease. Expect multiple pre-operative eye examinations before a definitive date is set for your cataract surgery.
• Pre-op treatment to reduce inflammation (or the risk of inflammation): Autoimmune conditions often cause internal eye inflammation. You may be given medication to reduce the risk or prevent it from occurring.
• Taking preemptive antibiotics: While this isn’t a given, certain conditions will require the use of “just in case” antibiotics to reduce the chance of any postoperative infection.
• Additional monitoring: Your cataract surgeon will  want to keep a close eye on you in the days and weeks after surgery. This is so they can spot any inflammation and/or infection at the earliest stage when it’s easiest to treat. 

Depending on your condition, you may need to see a specialist surgeon. While there are many ophthalmologists who perform non-complex eye operations, there are fewer who specialize in cataract surgery in those with autoimmune disorders. You should be guided by your eye doctor and disease consultant as to whether you should seek specialist care.

The main aim of eye surgery in those with autoimmune disease is to prevent post-op swelling and infection. Every pre-, during, and post-op step is done to reduce this. Of course you’re going to worry, But the improved vision after you’ve had cataract surgery can be totally life-changing.

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