Cataract after ICL

Post your questions and start your research in this forum if more than three months ago you had any type of surgery to reduce the need for glasses and contacts.

Cataract after ICL

Postby beingbobbyorr » Wed Oct 26, 2011 9:08 am

I had my Visian ICL surgery in December 2008, at age 48, starting from -7.5 and -9 diopter contact lens scripts.

Goal: optimize distance vision in both eyes, NO monovision.

Results were virtually perfect:

-- 20/15 in left dominant eye
-- 20/20 in right non-dominant eye
-- no ocular pressure issues in either eye
-- no Halos or PILIs in either eye
-- only slight double-image effect when looking at distant traffic lights at night (no big deal)

Couldn't be happier w/ my vision throughout 2009 & 2010.

Gradually over the course of 2011, I noticed a degradation of my distance vision in the right eye, plus a diffusion of light in both eyes (but more so in the right). I was worried that the loss of vision in the right eye was due to a shifting of the ICL in the posterior chamber (or did my eyeball change shape again, at the ripe old age of 50?) and that the diffused light might be caused by loss of endotheliel cells (a post-ICL risk). So two months ago I went to see my ICL surgeon to get a checkup.

The ICL surgeon thought the vision loss in the right eye was too minor to be significant. When I broached the idea of doing a Lasik tweak, he said that he'd be willing to do it, but that, because of variances in flap healing, the results may not be any better than what the right eye is currently capable of.

I said I'd think it over and get back to them.

Over the next few weeks, I kept testing my vision to try to judge just how bad it was and whether I could live with it as is. I concluded that it was too distracting, and needed to get fixed. Then I remembered that during my 2007-08 "vision-quest" (going to tons of refractive surgeons to decide between Lasik vs. ICL) I stumbled across a pure-Lasik (did not do ICLs) surgeon who I liked a lot. So I made an appointment with him to see if he thought he could nail a Lasik-tweak more closely than my ICL surgeon felt he could.

Now, for the kicker. This pure-Lasik surgeon did something that my ICL surgeon had not done: he dilated my eyes. And what did he discover? Cataracts in both eyes (the right eye more advanced than the left).

We all know that cataracts are a risk of ICL surgery. And I knew that the risk of cataracts is even greater the older you are (that's why the clinical study focused on people < 45 years old). So none of this is a total surprise, nor is there any blame (for the cataracts themselves) to be laid here. I had merely forgotten about the cataract risk since it had not cropped up in 2009-2010. The only thing I can chastise my ICL surgeon about is his failure to dilate the eye to look for cataracts (for which decreased visual acuity is a primary indicator).

So now I'm engaging with my HMO to get them to acknowledge my cataracts, see what they'll pay for, and figure out what surgeon I want to do it.

The reason I tell this story is to remind potential & past ICL patients that

a) You must get it clear who (ICL surgeon vs. your regular OD) is going to measure/track various characteristics of your post-ICL eye health

b) No matter who (ICL surgeon vs. your regular OD) is doing cataract detection, they're not being thorough if they aren't dilating your eyes


In hindsight, there are a couple of red flags that I gradually noticed about the ICL surgeon I choose, but there was no way to evaluate this before surgery .....

c) His office staff rarely, if ever, called me after the ICL surgery to prompt me to schedule checkup appointments. (Hell, even my dentist's staff does this!)

d) The doctor, although he's a nice guy and is never in any way rude per se, always seems to be in a rush during the brief amount of face-time I get when I do come in for a post-op visit. It's like his mind is only half on my case.
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