Lens Implants after LASIK

Question: I had cataract surgery in my left eye 10 days ago. I have terrible halos, rings and pentagon shaped bright lights around all lights at night that are unbearable. I also have blurriness for distance that is much worse than before surgery and double vision. I had LASIK done with monovision 5 years ago with relatively good success. I'm 59 years old. Yesterday my cataract surgeon told me the best solution is to remove my Technis® Lens Implant he had put in as soon as possible and put in a monovision lens or a Crystalens® lens before doing the left eye. I have astigmatism. Which do you think I should choose for my eyes?

Answer: Lens implants after LASIK can be tricky. Depending on the type of LASIK you had and the presence of corneal aberrations, as well as any contrast reduction from the LASIK flap-one needs to VERY carefully select the type of lens implant AND consider optical aberrations and if they are going to interfere with lens implant optical performance. Further, the multifocal lens implants in and of themselves cause many of the symptoms you are describing. You need to have an aberrometry, a careful examination of the placement and position of the lens implant and a determination of the likely cause of your symptoms-only then will it be possible to make the best choice. Certainly the lowest risk choice is to avoid the multifocal or accommodative lens implant and stay with a monovision correction. Last, if you have a meaningful amount of astigmatism this needs to be carefully considered as well so as not to leave it uncorrected. Both the monovision option with a toric lens implant or a Crystalens® toric lens implant can hopefully address that for you. 

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

ReSTOR® Multifocal Lens Implant & Astigmatism

Question: Four months ago had cataract surgery using ReSTOR® Multifocal Lens Implant in both eyes including corneal relaxing incisions for previous astigmatism. I am adjusting to the various distances for reading and computer and the need for good lighting. However my distance vision is blurry so have a problem reading street signs until almost on top of them.  It has been suggested that more relaxing incisions should be done and in the office. 

Answer: It is impossible to know whether you might need additional relaxing incisions as it is not obvious whether the cause of your distance blur is indeed uncorrected astigmatism. Generally if one has a meaningful amount of uncorrected astigmatism it would also impact clarity at other distances and not just distance vision. Before having additional relaxing incisions you might want to get a second opinion and definitive reason for the decreased distance vision. While it could very well be due to the astigmatism, it could be due to other causes or just an inability to tolerate and get the desired performance from that lens implant design-which does cause a considerable contrast reduction. And, it may be that an alternative to the relaxing incisions might provide the beast clarity.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery Risk & Diabetic Retinopathy

Question: I have had Type 1 Diabetes for close to 34 years and have had vitrectomy and scleral buckle on my right eye 20 years ago along with a gas/fluid exchange. The buckle is still nice and low in that eye and I also developed a cataract and had cataract surgery and a lens implant 8 years ago. I have now developed a cataract in the left eye at age 52. I have also had PRP diabetic retina laser in both eyes. Most of my peripheral vision has been lost in the right eye after the vitrectomy, so my question is, should the cataract surgery be done immediately on my left eye since my quality of life is not being impacted and I still correct to 20/20 in the left eye with full peripheral vision. Are there also greater risks to the cataract surgery now that the PRP was performed years ago? I currently see a retinal specialist and also an ophthalmologist who is a cataract surgeon.

Answer: Generally, the decision to have cataract surgery is up to the patient based on whether there is any decline in quality of life, mobility limitations or safety concerns because of diminished vision from the cataract. If you still correct to 20/20 and do not experience any limitations you can delay the cataract surgery until you judge that it is a problem. There should be no increased risks due to the PRM but your retina specialist will most likely consult with your cataract surgeon and clear the stability of retina and vitreous for surgery when it is time.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.