Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission
Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
Click the orange button to the right to learn more about what you can start doing today.
Yes, dexamethasone-induced cataracts are a common side effect of therapy that involves dexamethasone for multiple myeloma. But when I had my cataract surgery in 1996 I thought that this was one of the easiest side effects of MM therapy of any side effects that I knew of.
Skip ahead almost 30 years. According to the article linked below, cataract surgery is safer with more choice of outcomes than ever.
I am a long-term MM survivor. I spend time talking to MM patients about many different aspects of their experience. Few MM patients talk about problems with their cataract surgery.
The short video below will give you a sense of what cataract surgery entails.
What are the possible side effects of cataract surgery?
Common Side Effects
Temporary Discomfort
Mild pain or discomfort in the eye
Grittiness or feeling of something in the eye
Blurry Vision
Vision may be blurry for a few days or weeks as the eye heals.
Dry Eye or Irritation
Temporary dryness or irritation can occur due to changes in tear production.
Light Sensitivity
Increased sensitivity to light in the first few days after surgery.
Redness or Swelling
Minor swelling or redness around the eye, which usually resolves with time.
Less Common Side Effects
Posterior Capsule Opacification (PCO)
Cloudiness of the lens capsule months or years after surgery. Treated with a quick laser procedure (YAG laser capsulotomy).
Infection (Endophthalmitis)
Rare but serious infection inside the eye. Symptoms include severe pain, redness, and vision loss.
Inflammation
Persistent swelling of the cornea (corneal edema) or other parts of the eye.
Retinal Detachment
A rare complication where the retina pulls away from the back of the eye, leading to vision loss if untreated.
Glare, Halos, or Double Vision
Some people experience glare, halos around lights, or double vision, especially at night.
Increased Eye Pressure
Elevated intraocular pressure (IOP), which may require treatment to prevent glaucoma.
Dislocated Intraocular Lens (IOL)
The artificial lens may shift from its correct position, potentially requiring repositioning or replacement.
Very Rare but Serious Risks
Loss of Vision
Extremely rare, usually associated with severe complications like infection or retinal detachment.
Corneal Damage
Permanent damage to the cornea requiring further treatment.
Technological advancements and the development of intraocular lenses (IOLs) have significantly improved the care of patients with cataracts, especially for those who would prefer not to wear glasses.
Dr Gerd Auffarth, president of the German Ophthalmological Society (DOG), explained the advancements in diagnostics, surgical safety, and the range of IOLs at a press conference during the 122nd DOG Congress in Berlin…
Enhanced Pathology Detection
These advancements contribute to the indication and surgical strategy for the procedure. “Diagnostics are particularly important to exclude other eye pathologies that could suddenly cause problems during surgery or that are relevant for the choice of IOL,” Auffarth explained.
Improvements in anterior segment OCT and Scheimpflug technology have enabled early detection of subclinical changes, such as early Fuchs endothelial dystrophy or corneal bulging anomalies (keratoconus). In addition, optic nerve and macular changes can now be identified much earlier. Such conditions can be contraindications to implantation of specialty lenses aimed at dispensing with the need for corrective eyewear.
Increasingly, according to Auffarth, artificial intelligence algorithms are being used for image data analysis and calculation of suitable IOLs.
Innovations in Intraoperative OCT
“The surgery itself has also become even better and safer,” Auffarth said. With the use of novel surgical microscopes combined with 3D glasses and a large screen, the surgeon no longer needs to look through eyepieces but can view the surgical field freely in the room. The image quality and depth perception are impressive, according to Auffarth.
Additional diagnostic options, such as intraoperative OCT, and surgical guidance systems similar to a vehicle’s head-up display have been introduced.
Safer Surgeries
The gold standard for fragmenting the cloudy lens, ultrasound-based phacoemulsification, and subsequent suction of lens fragments is now performed in a minimally invasive way, according to Auffarth…
In contrast, older systems could generate pressures of up to 60 mm Hg, which have been associated with an increased risk for postoperative corneal damage and a heightened inflammatory response. “With the enhanced safety profile and the broader range of specialty lenses, we can successfully operate on more patients who were previously advised against implantation of a specialty lens for one reason or another,” Auffarth said. In addition, this is now possible for many patients with early glaucoma without optic nerve damage or those with well-controlled diabetes without retinopathy.
More Specialty Lenses
The most commonly used IOLs in cataract surgery are monofocal lenses. These lenses are regarded as having the highest image quality and have a single focal point, which can be chosen on the basis of personal preference for distance, near, or intermediate vision. Corrective eyewear is then necessary for optimal vision in the other areas.
If the goal is to avoid glasses or contact lenses after surgery, alternative IOLs are available. These include specialty lenses with multiple focal points, lenses with extended depth of focus (EDOF), and lenses for astigmatism correction (toric lenses). In the context of refractive lens surgery, such as for correcting presbyopia (age-related vision loss) without cataracts, these premium or specialty lenses are increasingly being used in younger patients.
Alternative to Trifocal Lenses
For a long time, trifocal lenses — those with three focal points — were the most commonly used specialty lenses. These lenses utilize a specialized optical configuration to disperse light into distinct focal areas, facilitating distance, near, and intermediate vision. This technique results in some loss of contrast and partial overlap of focal lengths.
Despite advancements that have reduced light loss from up to 20% to below 10%, “trifocal lenses remain susceptible to light-related side effects such as halos or glare and scattering light phenomena, which is why they are no longer the undisputed first choice,” Auffarth said.
The strongest competition now comes from EDOF IOLs, which no longer have clearly defined focal points. Instead, their focus is distributed over a relatively wide range. The biggest advantage is the reduction in light-related side effects, although there may be some limitations in near vision. The growing popularity of these lenses is demonstrated by a survey from the European Society of Cataract and Refractive Surgeons, which found that in 2023, nearly as many depth of focus lenses as trifocal lenses were used.
Combining Different IOLs
However, both lens systems can also be combined using a mix-and-match configuration. “For example, combining an EDOF IOL in one eye and a trifocal lens in the other eye can be a good option in individual cases to reduce side effects,” Auffarth said.
Monofocal-plus lenses have also been available for some time. These are single-focus lenses with a depth of focus that permits sharp distance vision and some intermediate vision. In the so-called monovision strategy with these lenses, one eye is set to 0 diopters, while the other is slightly nearsighted at minus 1 diopter.
Another alternative is the “blended vision” approach. “Here, we use EDOF IOLs so that one lens provides distance vision, while the other provides near vision, and together they cover the intermediate range.” According to Auffarth, EDOF and monofocal-plus lenses are increasingly being used in patients with moderate pathologies.
“Overall, interest in and acceptance of specialty lenses are increasing, and many patients are specifically asking about scientific studies in this area,” Auffarth said. Whether a patient is truly suitable for this option is always determined through thorough diagnostics and counseling…”
I was diagnosed in 2017 and had to have surgery in 2018 and had remission in 2020 and my eye sight is really bad again. Just waiting to go back for help I am so tired but God wakes me up everyday and I see my family.
