Question: I have a question about cataract surgery and lens implants after laser eye surgery for farsightedness. I am 57 years of age and had laser eye surgery for farsightedness 8 years ago.(+4.00 D and +4.50 D). I needed a redo as my vision in artificial light was very poor. The redo did help but I have been left with poor night vision. I now have some cataracts and my eye surgeon wants to do a lens implant IOL. He has told me that I will still need glasses after for close work. At present I need them also for distance. We also have a family history of glaucoma. Do you think I should go ahead now or wait for perhaps new technology?
Answer: The overall success of Laser Eye Surgery for higher degrees of farsightedness is somewhat limited as most patients find that there is poor stability of their prescription and vision and that they do in fact require repeated laser procedures-after which the vision still may not be satisfactory. Today-for someone 57 years old-most Refractive Surgeons who are also Cataract Surgeons would opt to perform a lens based procedure by removing the crystalline lens and replacing with a Lens Implant as the primary procedure for prescriptions in the range you describe. At 49 years of age when you had your Laser Eye Surgery it might not have been recommended at that time. NOW, without an examination it is impossible to tell whether your difficulty with night vision is a result of the formation of the Cataracts or due to a loss of contrast sensitivity from the laser treatments for your hyperopia and the possibility of some induced aberrations. This can most likely be determined by a Cataract & Refractive Surgeon with proper measurements and instrumentation. ALSO, the fact that you have had two Laser Eye Surgery procedures for the correction of your farsightedness makes the measurement and the calculation of the Lens Implant power somewhat more complex and this must be done very carefully. That said, if you have the beginnings or even more advancing Cataracts, having any further Laser Eye Surgery is not a good idea and improving your vision will require the removal of the Cataracts and Lens Implants.
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