Corneas and cataracts

When performing cataract surgery, it is important to realize that the surgery puts energy into the eye. That energy can damage the inside of the cornea. I often have conversations with patients in which I tell them that the “inside part of [their] cornea doesn’t work as well as it could.” This means that I observe exam findings that indicate to me that the inside part of the cornea is already more “fragile” than it is in general. In this case, I plan to make adjustments that I don’t do as part of normal cataract surgery in order to accommodate for this “fragility.” Sometimes there is more that we need to discuss, but that is not always the case. I think that it is an important part of the cataract evaluation to recognize when the cornea is vulnerable in this way. This aspect is sometimes missed, and it can lead to suboptimal outcomes.