Post-Pharco Cataract & LASIK?

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Post-Pharco Cataract & LASIK?

Postby CraziED » Wed Nov 14, 2007 7:31 pm

Hi,

I had pharco cataract surgery 2 months ago for PSC with an AcrySof Toric IOL. My vision now is +1.25 with minimal Astigmatism at -0.50.

My questions are:

Would LASIK or Piggy-back IOL be recommended to correct my small amount of refractive error?

Would the LASIK just correct my distant vision or would it also enable me to see near objects clearly as well?

Just need to clarify since I know that with cataract surgery, my focusing ability is now gone, so would LASIK be advisable for just +1.25 of distant error if this is the case?

Also, newer LASIK technology now enables Presbyopia to be corrected. Since Presbyopia is the degeneration of focusing ability of the eye on near objects, would such LASIK help the focusing ability of my IOL implanted eye in anyway?

Or would I be able to only correct refractive error of one distant only, and will still need glasses for other distances?

Thanks!

P.S. Oh, by the way, I posted my question here because I did have Tissue-Saving Lasik for the other eye as well, and I'm still trying to accommodate to the 'Sudden Presbyopia" I'm experiencing. But as I'm only 24, my surgeon says my muscles should be able to adapt over after some time. Though I'll need a 2nd enhancement to rectify the under corrected astigmatism I have of about -1.50. I'm quite happy with my LASIK though, been about -8.00 and now can see without spectacles for distant vision - amazing!
CraziED
 
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Re: Post-Pharco Cataract & LASIK?

Postby LasikExpert » Thu Nov 29, 2007 4:34 am

CraziED wrote:Would LASIK or Piggy-back IOL be recommended to correct my small amount of refractive error?


Your small refractive error is actually larger than it may at first appear. Hyperopia after cataract surgery can provide poor vision quality even with corrective lenses. Your surgeon should recommend what procedure may be best if you want additional surgery to resolve this refractive error.

I highly recommend that you use contact lenses for a few weeks to affirm that the difference is enough to warrant the risk (no matter how small) of additional surgery.

CraziED wrote:Would the LASIK just correct my distant vision or would it also enable me to see near objects clearly as well?


Lasik can only do what you are able to do with contact lenses. Lasik will not restore your ability to see both near and distant objects without adding glasses for one or the other, however monovision Lasik may reduce the need for reading glasses. Read the detailed article.

CraziED wrote:Just need to clarify since I know that with cataract surgery, my focusing ability is now gone, so would LASIK be advisable for just +1.25 of distant error if this is the case?


Whether or not Lasik is appropriate will need to be determined by your surgeon, but I very highly recommend you consider a surface ablation technique like PRK or LASEK that does not require the use of a microkeratome.

CraziED wrote:Also, newer LASIK technology now enables Presbyopia to be corrected.


No, it does not. This is pure marketing hype and bordering on smoke and mirrors. Lasik can not correct presbyopia. Nothing can. Everything that is designed to reduce the need for reading glasess is a workaround of some sort.

CraziED wrote:Since Presbyopia is the degeneration of focusing ability of the eye on near objects, would such LASIK help the focusing ability of my IOL implanted eye in anyway?


No. Changing focus (accommodation) is performed by the natural crystalline lens within the eye. Cataract surgery removes the natural lens and replaces it with an artificial intraocular lens (IOL).

There are multifocal IOLs and there are pseudo-accommodating IOLs, but nothing predictably and reliably restores accommodation. THere are manufacturers who will argue for their multifocal or pseudo-accommodating IOLs, but these are not true accommodation that you would achieve in your other eye.

CraziED wrote:Or would I be able to only correct refractive error of one distant only, and will still need glasses for other distances?


One distance only, or there is some sort of compromise (such as multifocal and pseudo-accommodating IOLs.)

CraziED wrote:P.S. Oh, by the way, I posted my question here because I did have Tissue-Saving Lasik for the other eye as well, and I'm still trying to accommodate to the 'Sudden Presbyopia" I'm experiencing. But as I'm only 24, my surgeon says my muscles should be able to adapt over after some time. Though I'll need a 2nd enhancement to rectify the under corrected astigmatism I have of about -1.50. I'm quite happy with my LASIK though, been about -8.00 and now can see without spectacles for distant vision - amazing!


Wow. Cataract at age 24?! Was this induced by steroids?
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Postby CraziED » Mon Dec 17, 2007 8:42 pm

Thanks for the tips.

There's an ongoing argument of the cause of my cataracts - the eye experts says its due to steroid creams usage for my eczema, while the skin experts says its too negligible to be considered a potential risk. The verdict is still out after 5 long years!

I don't quite get your statement:
Your small refractive error is actually larger than it may at first appear.


Did you meant that as the epithelium is still healing, the refraction may not have settled down properly yet? So I should expect the refractive error to have some minor adjustments - perhaps reduction?

I know the risks involved with a cataract-ed eye - 5 times increase in chances of getting a retinal detachment. So I think I will settle for a 100+/- hyperopia for distance and 200+/- for computer work. I think the changes, as you mentioned, may just not be worth the risks involved.

As for the LASIK-ed eye. All I can say is the -125 of astigmatism is really killing me. I can't read or use the computer without my reading glasses. (I had one made so that both eyes' refraction are balanced out, as one is a '+' and the other a '-'. I know there's a word for balancing problem, but it eludes me. )

I guess an enhancement is necessary to correct the miserable astig. The decision probably will be made during my next doctor's visit in about 2 months time.

On a brighter note, when my LASIK-ed eye is ripe for the plucking (cataract surgery), I've found a potentially satisfactory option for myself - blended vision. Basically it means that one eye's IOL is set for distance vision, while the other is focused for mid-range. This way, I can still see a wider range of distance without the aid of glasses.

This is a relatively new approach to cataract surgery. But it is getting good reviews from surgeons and patients alike...so it's a potential candidate!
CraziED
 
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