Great question about Cataracts: Should you wait till it “ripens”

Do cataracts have to be “ripe” before that are to be removed? Or can it be done at any time? I was told by a local eye doctor that I have cataracts and wanted to set up an operation to have them removed. I suggested that we wait a year and then re -evalua

Years ago, cataract surgery had significant risks (infection, loss of vision, eye) which may or may not have outweighed benefits. While these risks are still present, they are significantly less: thus benefit often outweighs risk extensively. If best vision is worse than 20/40 or glare is significantly affecting vision, most surgeons prefer to do surgery sooner as less energy needed to remove a softer cataract compared to a denser one. Our goal is always to decrease the amount of energy (ultrasound) we pump into the eye as this energy can damage delicate cells in the eye (corneal endothelial cells which can lead to the clouding of the cornea requiring corneal transplant in older corneas after cataract surgery; retinal cells which can lead to swelling of the macula [CME: cystoid macular edema]; and increase overall post-operative inflammation.

Thus the vast majority of surgeons prefer to remove a softer cataract than a harder one for this reason. Still, though, the final decision is up to you and your surgeon. If you have other risk factors, such as you only have one good eye, or you had a complication in the other eye, or you are on flomax and had difficulty in the other eye or you had a bout of uveitis or inflammation in the eye, your eyeMD knows you and your eye the best out of anyone and likely does want the best for you. If the cataract is small, waiting a period of time to follow will very likely do no harm. 

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