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Currently Viewing. A patient presents to you with a unilateral mature white cataract, and before booking her surgery, you have a hunch that something isn't quite right This year-old woman has a complaint of poor vision out of the left eye for 40 years. She recalls some unspecified trauma at the age of 20, then slowly losing vision in the left eye.
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Nick Mamalis is an anterior segment surgeon who is fully certified as an ophthalmic pathologist after completing a fellowship under David Apple. He continues the work on the post-mortem pathology of eyes containing intraocular lens implants and has supplied much of the data on the incidence of problems associated with the different styles and materials of IOLs, as well as those that seem to be best. Over the years, he has also been available as a consultant to individuals and surgery centers that have had problems with endophthalmitis and episodes of TASS. He is an editor of the Journal of Cataract and Refractive Surgery, a frequent speaker at national and international meetings, and a major contributor to the literature as well. The case he discusses today is one that confronts all of us on occasion, and his description reminds us of the challenges associated with such cases.
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The types of cataracts that pose the greatest challenge to the ophthalmologist include the dense brunescent cataract, the white cortical cataract, and the posterior polar cataract. Each type is unique in the specific surgical challenge it poses and the complications that may result. There is a spectrum of behavior for white cataracts.
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