Other eye conditions that affect outcomes

Cataract surgery improves optical clarity, but it cannot “fix” retinal or optic‑nerve disease. These comorbidities influence lens choice, expectations, and follow‑up.

Glaucoma Diabetes High myopia Retina

Practical takeaway

If your eye has multiple issues, the “best” IOL is often the one that minimises optical trade‑offs and preserves contrast (frequently a monofocal).

Glaucoma

What changes: you may have reduced contrast sensitivity already.
Lens choice: many surgeons prefer monofocal IOLs (multifocals can worsen contrast/haloes).
Plan: discuss whether to combine cataract surgery with MIGS or stage procedures.
Monitoring: visual fields and OCT remain important after surgery.

Diabetic retinopathy

What changes: risk of macular oedema may rise, and retinal disease limits vision potential.
Timing: retina treatment (laser/injections) may be needed before/after cataract surgery.
Lens choice: contrast-preserving options are often favoured; ask about blue‑light filtering IOLs if relevant.

Age‑related macular degeneration (AMD)

Expectation setting: cataract removal can brighten vision, but distortion/central blur from AMD may persist.
Lens choice: multifocal IOLs are often avoided in significant macular disease.
Follow‑up: continue home monitoring (e.g., Amsler grid) and retina reviews.

High myopia

Higher retinal detachment risk compared with non‑myopic eyes.
Biometry is harder; refractive surprises are more likely.
There may be pre‑existing retinal thinning/degeneration.
Ask whether a retinal exam is recommended pre‑op (and whether prophylactic treatment is ever indicated).

Other important considerations

Condition	Why it matters	Common planning implications
Fuchs endothelial dystrophy	Cornea may swell and stay hazy after surgery.	Gentle surgical technique; sometimes combined or staged corneal procedures.
Uveitis / inflammatory eye disease	Higher inflammation and CME risk.	Inflammation control before surgery; tailored steroid/NSAID regimen.
Pseudoexfoliation	Zonular weakness can complicate surgery; later IOL/bag instability.	Capsular support devices; long‑term monitoring.
Prior vitrectomy	Biometry and capsule behaviour differ; higher complication complexity.	More detailed planning; sometimes different IOL choices or fixation.