Extreme hyperopia/astigmatism

[can2]

Hi there

I have extremely high hyperopia and astigmatism.
Left eye, +6.75
Right Eye +5.50

Astig

Left +4
Right+3.5

I plan on doing and ICL and lasik to correct both problems. Should i go ahead with it? Will there be any repercussions? It is advisable? Thanks for any help that I can get.

[Remander]

Have you had a consult with a doc? Many docs do the initial consult for free and will give you info on whether you are a good candidate.

[LasikExpert]

I plan on doing and ICL and lasik to correct both problems.

There is no way we can (or would) tell you what to do regarding elective vision correction surgery. The most we can do is provide you some details about what you are considering and you can make your own decision.

If you are in the US it will be impossible to have a phakic intraocular lens (P-IOL) like the STAAR Implantable Collamer Lens (ICL). They are not approved for hyperopic correction.

Even outside of the US it is not likely that an ICL will be appropriate. Hyperopic patients tend to have a very shallow chamber inside the eye where the lens would be implanted. This shallow chamber can make an ICL dangerous or impossible.

An important issue with any P-IOL is the loss of endothelial cells. The endothelium is the innermost layer of cells of the cornea. A P-IOL can cause an accelerated loss of these cells. In time, the endothelial cell count can get low enough that the P-IOL must be removed. How much time depends upon how may cells you have when you start (a cell count needs to be taken before surgery) and how rapidly you lose cells (a cell count every year is wise).

Remember that in all cases a P-IOL is temporary. If you live long enough you will likely develop cataracts and the P-IOL will need to be removed to allow cataract surgery. Between the endothelium and cataracts the use of a P-IOL is limited, but that limit may be 10-20 years, depending upon your unique circumstances.

Although your astigmatism is (barely) within range for laser vision correction surgery, such high astigmatism is a challenge for Lasik.

If you are at or past age 40 you may want to consider Refractive Lens Exchange (RLE) as an alternative to a P-IOL. You would still have the difficult challenge of the astigmatism, but it is something to consider.

You are not likely going to be considered an excellent candidate for any of the techniques or technologies available today. You may be an acceptable marginal candidate, but you will only know after a comprehensive evaluation from a competent doctor.