An Open Letter from a Retina Specialist to Cataract Surgeons

Why thorough retinal screening before cataract surgery can safeguard outcomes, shape surgical planning, and reveal risks hiding beyond the lens

By
Paulo Eduardo Stanga
July 8, 2026
8 min

The Ophthalmologist

Objective:

To highlight the necessity of thorough retinal evaluation in preoperative assessments for cataract surgery.

Approach:

Pre-operative Screening: Discusses the necessity of comprehensive retinal examinations, including slit-lamp and indirect ophthalmoscopy, and highlights the challenges of traditional methods.
Digital Retinal Imaging: Explores the advantages of widefield (WF) and ultra-widefield (UWF) imaging technologies for detecting peripheral retinal lesions and improving workflow efficiency.
Surgical Planning and Legal Considerations: Addresses the role of fundus imaging in documenting preexisting conditions for medicolegal purposes and tailoring surgical plans based on retinal findings.

Key Findings:

Undiagnosed retinal pathology can compromise postoperative outcomes in cataract surgery.
Digital retinal imaging techniques enhance detection of peripheral lesions and improve preoperative assessments.
Documentation of retinal findings is crucial for legal protection and informed surgical planning.

Interpretation:

Cataract surgeons should integrate comprehensive retinal evaluations into their preoperative workflows to mitigate risks associated with undiagnosed retinal conditions.

Limitations:

Traditional retinal examination methods are time-consuming and require high expertise.
Younger ophthalmologists may lack experience with certain examination techniques.