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Cataract Surgery Question

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    Cataract Surgery Question

    Having cervical injury and dealing with AD is it possible to have local anesthesia? To my understanding AD episodes occur below injury site. My eye would be above cervical injury. Am I correct? My surgeon knows nothing about AD. I would rather have local than general as long as I won't have an AD attack.

    From my experience, I would recommend that you have a general rather than a local anesthesia for your cataract surgery. My rationale has nothing to do with autonomia.

    I've had cataracts removed from both eyes. I am C6/7 complete. My opthalmologist/surgeon recognized what he felt was a spinal cord injury related problem with my eyes that caused my surgeries to take longer and be more complicated than normal. My pupils are very tiny and don't dilate very much either naturally or with medications. My physician reasoned that since the eyes have spincters, my spinal cord injury may have something to do with this dilation problem. He had to use stretchers to get my pupils large enough to remove the lenses and insert the artificial lenses. This also limited the type of lenses I could have inserted. I would not have wanted these surgeries under a local anesthesia, and my doctor would not have performed these surgeries under local anesthesia.

    I don't know if your eyes have difficulty dilating, but it might be worthwhile discussing this with your surgeon at one of your pre-op appointments.


      Yes, your autonomic nervous system controls pupil size, and these nerves travel from your brain down the spinal cord to the cervical cord, where they exit the cord and travel back up to the brain and eye via a nerve called the "sympathetic trunk" (which lies right next to your carotid arteries in your neck). This can cause some people with cervical injuries to have smaller pupils, and may result in the eye drops used for pupil dilation for exams or surgery not to work properly. Tell your eye doctor it can be like Horner's Syndrome (an eye surgeon should know about this).

      That being said, most cataract surgery is done now days with a combination of local anesthesia for the eye itself, and IV "moderate sedation".

      AD can occur during any surgical procedure even if above your level of injury if you are not properly positioned, or someone is leaning on your body during the procedure...but it would not be the surgery itself.

      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.


        Thanks so kindly for the replies. Was hoping for local so will tell my surgeon