choice of IOL for cataract

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choice of IOL for cataract

Postby SSMuri » Sat May 26, 2007 8:02 am

I am 55 and have presbyopia in rt.eye recquire bifocal.No cataract
I have a cataract in the left eye and am at a point of needing surgery.
I am contemplating accomodative or multifocal lens for cataract eye followed by lasik for theother eye .
1.will this help me to be functional without glasses for the most part?
2.how good is lasik for presbyopic vision correction?
3. which lens would be the best for IOL in my position>

I have read a lot but still difficult to understand implications.

Please help
Thanks a million
SSMuri
 
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Joined: Sun May 20, 2007 5:44 am

Postby LasikExpert » Wed May 30, 2007 6:29 pm

The implications of the choice of intraocular lens (IOL) can be significant, as illustrated in a recent peer-reviewed article published in Clinical & Experimental Ophthalmology, Volume 35, Number 4, May/June 2007, pp. 355-360(6).

Aberration and contrast sensitivity comparison of aspherical and monofocal and multifocal intraocular lens eyes

Conclusions:;

Although the multifocal IOL can provide near vision, it can increase higher-order aberration and negatively influence contrast sensitivity. However, the aspherical IOL can reduce aberration and improve contrast sensitivity as compared with the monofocal IOL.


The single focus IOLs provided statistically significantly better vision quality than the multifocal IOL, and the aspherical single focus IOL provided the best quality of vision.

Multifocal IOLs are a tradeoff. You will likely have an increase in halos and a reduction in contrast sensitivity, but you will be able to better see objects near and far. Monofocal and aspheric IOLs provide good vision quality, but only for distance or near, not both.

Multifocal IOLs remind me of the story of the two elderly ladies in a diner. The one says, "The food here is terrible." To which the other replies, "Yes, and the protions are so small." Why would you want large portions of bad food?

The only accommodating IOL available in the US is the Crystalens. In theory, this lens moves within the eye to mimic natural accommodation. In the FDA clinical trial the Crystalens was able to perform well enough to gain approval, however the real-world application of the technology has been somewhat less stellar. The essence of the Crystalens is that when it works it can provide a maximum of about 1.25 diopters of accommodation, but it does not always work well and sometimes does not accommodate at all. There is no way to know if it will work until after it is in and after a long period of adaptation. The Crystalens can end up being a very expensive monofocal IOL, but when it works patients seem to love it.

You may want to discuss with your doctor if monovision correction with aspherical IOLs would be appropriate.
Glenn Hagele
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Choice of IOL

Postby SSMuri » Mon Jun 04, 2007 6:54 am

Thank you for your analytical reply.
When I posted my question ,I was tentatively scheduled for surgery. After a second visiit with the doctor,I decided to go ahead with surgery.
I have had cataract extrtaction with crystalens placement in one eye followed by LASK in the opposite eye .
I was quite nervous due to all the reasons you gave about crysatlens and the chances of this working or not working etc.

First day after surgery,I felt that I did not gain much near vision ;fair intermeditae and some far vision.lots of halos and glare at night!

By day 2 -much better.It was wonderful to wake up and see the tree branches and leaves through the window! glares and halos disappeared to a large extent.

day 2 proceeded with LASIK for the opposite eye.

presently ,almost 10 days post surgery and I am quite happy with the exetnt of improvement.I can work on computer without glasses,read font size 9 fairly well.

Crstalens vision is much brighter and whiter compared to the lasik eye.
Lasik correction actually seems to be a bit undercorrected.Don't know if this will improve any or not.

So far so good !!
I am told that crystalens may improve upto 1 year.
I will be watching..

Thank you once again.I will continue to follow up on your postings.It is very helpful.
SSMuri
 
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Postby LasikExpert » Mon Jun 04, 2007 5:27 pm

Thanks for coming back and telling us of your experience thus far. I will be very interested to know the results of your manifest refraction (which is better, one or two?). I'm curious how much of your near vision is due to monovision and how much is accommodation.

It is so soon after Lasik that it is not surprising that it is not as clear as the Crystalens eye. Also, you had a cataract before and that eye would have been looking through a light fog. You should really see improvement.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
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Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

CRYSTALENS/LASIK

Postby SSMuri » Tue Jun 05, 2007 7:15 am

It is funny you should bring up the questions you did. I was also thinking about the same issues.
I have a follow up in a week and expect to be tested and compared to previoous vision.I will try to get some additional answers at this visit.
All in all ,from everything I read so far,ophtholmology in general seems to be
an exciting area in medicine.
Thanks for your comments.
SSMuri
 
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Joined: Sun May 20, 2007 5:44 am


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