Question: I require a cornea transplant and lens implant IOL due to blunt trauma to my right eye with loss of a lens and a corneal tear. I have a small cataract in left eye. I have moderate myopia and mild presbyopia in both eyes-corrected with transitional progressive eyeglass lenses. What type of lens implant would be best and should I get the left cataract removed as well.
Answer: Unfortunately, we can only be of limited advice, as we don’t have enough information to give you specific answers. Let’s try, in any event.
First, you do not state and may not actually know the type of corneal transplant that you are having. There are a number of types of corneal transplants and some can actually impact the final refractive error of the eye more than others-thus making really precise Lens Implant calculations somewhat difficult in certain circumstances. Thus, selecting a Lens Implant type that requires a precise set of measurements-such as a Multifocal Lens Implant-is probably not a great idea.
Second, the fact that you have been wearing transitional progressive eyeglass lenses for myopia and presbyopia, is actually a good thing. Regardless of what the refractive outcome ends up being, it would appear that you are able to tolerate these types of eyeglass lenses for correction of the presbyopia. Given that you are moderately myopic, when your Cataract Surgeon calculates the Lens implant power for the right eye, he or she will need to discuss with you whether to approximate the preoperative level of myopia and attempt to match the left eye-or to fully correct it, as close as possible, to not needing any refractive correction and allowing you to function without any correction at distance in the right eye.
If this is chosen you will need to have the left eye Cataract removed to have it rendered clear for seeing distance. In this instance-which is the simplest and most predictable scenario-you would then need to have the transitional progressive eyeglass lenses for a mild distance vision correction and your presbyopia. It may, however, be possible that other options could be employed depending on the overall refractive condition of the left eye and what kinds of activities you wish to engage in, that might be easier or more convenient without eyeglasses. This is really going to depend on the specifics of your eyes and your specific vision needs. The best thing to do is to have these types of discussions with your Corneal Specialist, who we assume is also your Cataract Surgeon and come up with a plan that is likely to give you the best results.
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