Advice need on intraocular lenses and cataract surgery

Hi,

About a year ago, I underwent surgery for replacing a cataracted
lens with an intraocular lens (IOL) in one eye - unfortunately, I have
to have surgery on the other eye as well, and am curious about the
pros and cons of implanting an IOL of the opposite focus - that is, my
current IOL is a reading IOL - is there a benefit to implanting a
distance IOL in the other eye?

If there is a doctor that can provide a technical perspective, that
would great. Or if someone has undergone this procedure, I would like
to hear your experiences as well. Has different IOLs resulted in any
kind of double vision? Do you still need prescription glasses to read
or drive? Is there any medical danger in different lens? Is it
better to have the same lenses on both eyes?

Thank you very much for the help.

Paul

in article (E-Mail Removed), Paul A. Mathias
at (E-Mail Removed) wrote on 8/19/04 12:38 AM:

> Hi,
>
> About a year ago, I underwent surgery for replacing a cataracted
> lens with an intraocular lens (IOL) in one eye - unfortunately, I have
> to have surgery on the other eye as well, and am curious about the
> pros and cons of implanting an IOL of the opposite focus - that is, my
> current IOL is a reading IOL - is there a benefit to implanting a
> distance IOL in the other eye?
>
> If there is a doctor that can provide a technical perspective, that
> would great. Or if someone has undergone this procedure, I would like
> to hear your experiences as well. Has different IOLs resulted in any
> kind of double vision? Do you still need prescription glasses to read
> or drive? Is there any medical danger in different lens? Is it
> better to have the same lenses on both eyes?
>
> Thank you very much for the help.
>
> Paul

Go to "sci.med.vision".

Bill

"Paul A. Mathias" <(E-Mail Removed)> wrote in message
news:(E-Mail Removed) om...
> Hi,
>
> About a year ago, I underwent surgery for replacing a cataracted
> lens with an intraocular lens (IOL) in one eye - unfortunately, I have
> to have surgery on the other eye as well, and am curious about the
> pros and cons of implanting an IOL of the opposite focus - that is, my
> current IOL is a reading IOL - is there a benefit to implanting a
> distance IOL in the other eye?
>
> If there is a doctor that can provide a technical perspective, that
> would great. Or if someone has undergone this procedure, I would like
> to hear your experiences as well. Has different IOLs resulted in any
> kind of double vision? Do you still need prescription glasses to read
> or drive? Is there any medical danger in different lens? Is it
> better to have the same lenses on both eyes?

Whether you are comfortable or not depends on you, about 70% of people can
tolerate one eye for near, one for far -- called "monovision". Before
committing to the IOL, it would be good to have tried this out. After your
first surgery, was your unoperated eye focused for distance and were you
comfortable using one eye for near, the other for distance?

Some people find that they are okay around the house, outdoors and reading
large print or for short periods of time with monovision but like to have a
pair of distance glasses with correction for the near eye when driving and a
pair of reading glasses with correction for the distance eye when reading
finer print or for long term reading.

Dr Judy

"Paul A. Mathias" <(E-Mail Removed)> wrote in message
news:(E-Mail Removed) om...
| Hi,
|
| About a year ago, I underwent surgery for replacing a cataracted
| lens with an intraocular lens (IOL) in one eye - unfortunately, I have
| to have surgery on the other eye as well, and am curious about the
| pros and cons of implanting an IOL of the opposite focus - that is, my
| current IOL is a reading IOL - is there a benefit to implanting a
| distance IOL in the other eye?
|
| Paul

Here's a good place for info http://www.stlukeseye.com/eyeq/IOL.asp. And
within this link:

"New developments.
Lens implant surgery has become so advanced in recent years that its
benefits have been extended to healthy eyes. Phakic lenses (implanting an
IOL without removing the eye's natural lens) are an option that will soon
become available to young patients who may not be candidates for other
refractive surgery options. And CLEAR, a procedure available today, gives
patients over the age of 40 the option to improve their vision without
glasses and avoid cataract surgery later in life."

Wow. Preventive medicine is going places!

----------------------
Bob116

------
I have heard that John Kerry performed CPR on a hamster and the animal
survived.
I have heard that George W. Bush stuffed fire crackers in frog's mouths and
lit them.
Be sure to vote in November.

Some people like a difference, some people can tolerate it, and it
drives some people nuts. But there's no need to guess about something
that would require another surgery to change. Work with an optometrist
to simulate both cases (same focus and near focus) by using contact
lenses in the eye that still has the cataract. Soft, disposable
contacts are extremely comfortable and for a total additional
expenditure of a couple hundred dollars it should give you a very good
idea of what to expect. I did this before my first surgery and found
that I hated any difference, so now both of my eyes are focussed at
reading distance with glasses for distance.

Thank you very much to all for your pointers.

On the advice of attempting to simulate the experience with contacts,
there is a problem. See, I am theoretically already acheving
monovision with my IOL in the left eye being oppositely focal than the
focus of my natural right eye - and I am adjusting relatively well
with having one short distance and one long distance lens - the only
problem I have is the ability to drive unaided at night, because I
seem to have a difficult time focusing on objects in the absense of
much light.

The question I really have is there an issue with monovision induced
purely by two IOLs? IOLs obviously don't have the flexibility of the
natural eye's lenses, so I am concerned that having two oppositely
focused IOLs may create problems that I can't anticipate even with the
monovision I have today with one natural lens.

I don't believe a simulation purely with contacts would work because
ultimately what is impairing my right eye is the cataract, not the
fact that it is a different lens.

Is there any way to simulate on a person who already has monovision,
but with a cataracted natural eye lens what vision I can expect to see
with an IOL in that eye? Or is it safe to assume that if I can manage
with my current monovision, the monovision induced by two IOLs would
not be that different?

The other question I have is on the topic of multifocal IOLs - any
feedback on the effectiveness of multi-focals? I have heard it is a
high risk because the lenses can create kaleidoscope vision and then
it is impossible to repair since no contact or glasses can fix a
multi-focal lense - vs. even if I get monovision and I have problems,
I can always get glasses to change the focal lengths. Any feedback
that as well?

I greatly appreciate your help - thanks.