LASIK or P-IOL?

If you are thinking about having Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL eye surgery, this is the forum to research your concerns or ask your questions.

LASIK or P-IOL?

Postby milo » Thu Feb 15, 2007 9:58 am

Hello everybody,

I have a question regarding the fesibility of LASIK for correction of hyperopia. I have the following Rx:

Left eye: - 1,25
Right eye: + 3,75 -1.00 170

When fully corrected by glasses, I see 20/12 on both eyes.

I would like to alleviate the significant anisometropia I have, so now I am deciding between Visian ICL and LASIK (Zeiss MEL 80) to have done on my rigth eye, so that I would end up with - 1,25 D on both eyes.

Anyway, my doc said both were possible, but suggested LASIK to be the better option because it is "less invasive" than the ICL. I personally would prefer ICL, at least because it is reversible. Also, I think I have too thin corneas for LASIK (526 microns; other measurement by a different doc came to only 492 microns!), however, my doc said it was OK....

Now what do you think - LASIK or P-IOL?

Thank you for your help

Milo
milo
 
Posts: 4
Joined: Mon Feb 12, 2007 5:07 pm

Postby LasikExpert » Thu Feb 15, 2007 6:25 pm

The Visian ICL (Implantable Collamer Lens) is not approved in the US for hyperopic (farsighted, longsighted) correction. Also, the Visian ICL for astigmatism (toric) is not approved for the US. This means that you could not have your hyperopia with or without astigmatism corrected with the Visian ICL in the US.

Using a phakic intraocular lens (P-IOL) for a small refractive error such as your -1.25 makes no sense at all. P-IOLs are most indicated for high myopic correction.

The imbalance of refractive error from one eye to the other (anisometropia) can be quite problematic and would probaby provide even more vision quality problems as presbyopia limits the ability of the natural lens within the eye to change focus. I can understand your motivation for refractive surgery.

If you are fully presbyopic, then Refractive Lens Exchange (RLE) may be an appropriate option for the hyperopic eye.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

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

Postby milo » Fri Feb 16, 2007 9:01 am

Glenn,

thank you for your reply. Just to make it clear - I am considering having surgery done ONLY on my right eye, so after the surgery, I would have smthing like -1.25 on both eyes.

Further, I would have the surgery done in Europe, where hyperopic ICL has been used for years.

So, it appears I do have a choice between LASIK and the ICL, but not sure which one to choose.

Cheeres,

Milo
milo
 
Posts: 4
Joined: Mon Feb 12, 2007 5:07 pm

Postby LasikExpert » Sat Feb 17, 2007 6:00 pm

The Visian ICL will be significantly more invasive than would be Lasik, however high hyperopic correction such as yours would probably be more predictable with a P-IOL than with Lasik. That may seem to make the decision obvious, but there are some long-term issues to consider.

Eventually your P-IOLs will need to be removed. If you live long enough you will undoubtedly develop cataracts, which is when the natural lens of the eye becomes cloudy. Cataract surgery will require the removal of the P-IOLs, removal the natural crystalline lens within the eye, and implantation of an aphakic intraocular lens (IOL) to replace the crystalline lens and provide all the refractive correction.

Chances are that before cataracts develop you will become presbyopic. Presbyopia is when the crystalline lens is unable to change shape and thereby change focus to see objects near. Presbyopia is when bifocals or reading glasses are needed and usually occurs around age 40. P-IOLs are "helper lenses" that tend to be more ideal than IOLs when you are not presbyopic. With P-IOLs you are able to enjoy whatever focusing ability is provided by the crystalline lens.

If you are near or past age 40, then Refractive Lens Exchange (RLE) may be more appropriate than P-IOLs. RLE is exactly the same thing as cataract surgery.

P-IOLs are advantageous until you are presbyopic. After presbyopia sets in RLE may be more advantageous because it is only one surgery and would provide the refractive correction you seek. In other words, if you are presbyopic or near that age, you should consider skipping the P-IOLs and go straight to replacing the crystalline lens with an IOL.

If you are relatively young, the P-IOL helper lens could be reasonably considered to provide the most advantage. If you are at or past age 40 a P-IOL would arguably be an extra step toward the inevitable crystalline lens replacement with an IOL.

Another very important point about all P-IOLs but especially about the Visian ICL and hyperopic correction: be certain that your surgeon has had enough practical experience with implanting hyperopic Visian ICLs. Hyperopic Visian ICLs are quite different than myopic (nearsighted, shortsighted) ICLs and the slightest touch to the crystalline lens during surgery can cause trauma induced cataracts. No matter how much experience a surgeon has in other areas of intraocular surgery, you don't want to be his/her first hyperopic ICL.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

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

Postby milo » Mon Feb 19, 2007 10:22 am

Thank you again for your reply!

I am 28 so it appears that the ICL might be the best option.

I will surely ask the surgeon on how much hyperopic ICL correction he has performed. I actually didnt know that there is a big difference between how myopic and hyperopic corrections are made, so thank you for pointing that out!

Milo
milo
 
Posts: 4
Joined: Mon Feb 12, 2007 5:07 pm

Postby LasikExpert » Mon Feb 19, 2007 5:55 pm

Hyperopic and myopic P-IOL surgery is virtually the same, however the thickness of the P-IOL is different and requires exact measurements of the amount of space between the crystalline lens and where the P-IOL will be placed.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

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


Return to Thinking About It

Who is online

Users browsing this forum: No registered users and 2 guests