Wednesday, March 21, 2012

Multifocal IOL & Limbal Relaxing Incisions

Question: I recently had cataract surgery with Limbal Relaxing Incisions (LRI) to correct astigmatism and a multifocal IOL inserted. Initially my vision was perfect, but on the 10th day after surgery, there was a marked deterioration in mid to long vision, although my close vision was ok and I can read. My ophthalmologist is unsure what is happening, but seems to be of the opinion that the corneal cuts are healing, thus reinstating my astigmatism - which incidentally is 1.3 diopters. He is not keen to insert toric multifocal lenses, as he feels the only ones available at present are not very good and wants to delay my right eye until a preferred multifocal toric lens is available. I am not happy being left one eyed as my sight is very poor in the right eye. I am looking to get a second opinion but would welome any comments.

Answer: If you have had a regression of the astigmatism correcting effect of the Limbal Relaxing Incisions (LRI) it may be possible to redo them, however, it still may not produce the desired correction in a stable manner. This does happen in some instances. It may be possible to have either PRK or LASIK on this eye to correct the astigmatism and this should produce a predictable and stable astigmatic correction with a relatively low astigmatic correction. If you are in urgent need of Cataract Surgery and Lens Implantation in the other eye with a Multifocal Lens Implant, then you should discuss whether your eye is healthy enough for LASIK in the this eye in order to give you a better correction. Your Cataract Surgeon will of course need to qualify you to have LASIK in either eye based on the health, thickness and curvature of the cornea as well as the quality and quality of the tear film.

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