Considering phakic IOLs or RLE

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Considering phakic IOLs or RLE

Postby Spazzycat » Fri Dec 22, 2006 8:28 pm

I'm 48 years old, do very close work on the computer all day long, so I require two sets of glasses: one for distance and one for computer/reading work.

Several weeks ago, I had a pretty thorough evaluation with a Lasik surgeon. I am myopic (around -8, -9 in both eyes) with mild astigmatism in one eye. I have average corneal thickness, no high order aberrations according to the Wavefront scanner, but moderately dry eyes (which is why I no longer wear contacts). I was uncomfortable with the risks/tradeoffs of Lasik. I don't like the idea of taking off so much cornea; I might need some cornea some day. And dry eyes were a worrisome complication. I would not want to create a chronic dry eye situation for myself down the road.

My goal would be good distance vision. I don't mind wearing reading glasses for close-up work.

I am considering either phakic IOL (probably the Staarr Visian) or RLE.

My questions:

Why does the literature recommend phakic IOL only for those younger than 45? Are there any contraindications for anyone older than 45? I also noticed the FDA trials only studied patients up to 45 years old. Is that a coincidence?

RLE looks good except for the risk of retinal detachment (which truly is a scary risk). As a myopic, I understand that my chances of retinal detachment are higher, but if I live long enough, it's likely that I will need cataract surgery and RLE anyway. Does having RLE at 48 rather than at 75, for example, reduce this risk?
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Re: Considering phakic IOLs or RLE

Postby LasikExpert » Sat Dec 23, 2006 12:08 am

Spazzycat wrote:Why does the literature recommend phakic IOL only for those younger than 45? Are there any contraindications for anyone older than 45? I also noticed the FDA trials only studied patients up to 45 years old. Is that a coincidence?


The primary advantage of a phakic intraocular lens (P-IOL) such as the STAAR ICL is that it allows accommodation. Accommodation is when the natural lens of the eye changes shape and thereby changes focus to be able to see objects near. After age 45, accommodation is limited by presbyopia and a P-IOL would generally not be considered appropriate.

Spazzycat wrote:RLE looks good except for the risk of retinal detachment (which truly is a scary risk). As a myopic, I understand that my chances of retinal detachment are higher, but if I live long enough, it's likely that I will need cataract surgery and RLE anyway. Does having RLE at 48 rather than at 75, for example, reduce this risk?


The risk of having a retinal detachment with RLE now is virtually the same as with cataract surgery later (they are the same surgery), however if retinal detachment occurs now you will have vision loss now, rather than later.

Anyone with as much myopia as you should be evaluated by a retinal specialist before any elective surgery. Let the retina specialist give you the okay before you make a decision.
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