Lasik vs. PRELEX

I went to a doctor yesterday to discuss lasik, & he steered me toward
Prelex implanted lenses. He does both (as well as botox & laser
dermabrasion: is that normal for an ophthalmologist's office?). His
credentials seem impecable & he's been a surgeon for about 40 years
(not young). I'm finding it impossible to get objective information
about Prelex since everything I find on the net is written by surgeons
who are selling it. I'm 45, have a -4.50 prescription, wear soft
contacts, use reading glasses. He said it would be superior to lasik
w/ monovision & my vision would be stable for life. He did say I'd see
halos around lights. Anyone care to issue an opinion or suggest a
source for objective information? Thanks in advance!

Your doctor has told you about the ever-present problem with all
multi-focal intraocular lenses (IOL): you will see halos around light
sources. What the doctor obviously didn't say is what those halos
might mean to your day-to-day activities.

Halos can be severe enough to be almost totally debilitating in low
light environments. You may not be able to drive at night. You may
not be able to watch a movie in a dark theater. You may never again
have a candlelight dinner and know what you are eating or who is
sharing the table with you.

Of course it is possible (emphasis on "possible") that your halos will
not be so severe and would only be a minor nuisance, causing only
minor restriction on your activities.

At age 45 presbyopia has undoubted caught up with you. I recommend
that you try monovision with contacts (see
http://www.usaeyes.org/faq/subjects/monovision.htm) to determine
exactly what it would be like. About 2/3rds of people who try
monovision are happy with it and need reading glasses only
occasionally.

The idea of using a lens implant rather than LASIK is legitimate and
does seem reasonable, but I personally find the idea of implanting a
lens that you know is going to cause night vision difficulties as
foolishness. A standard monofocal IOL may be a better choice. Read
http://www.usaeyes.org/faq/subjects/rle.htm

If you feel adventurous with your eyes, you might even consider the
new Crystalens. See
http://www.usaeyes.org/faq/subjects/crystalens.htm

You may also find our 50 Tough Questions For Your Doctor
(http://www.usaeyes.org/faq/tough_questions.htm) helpful.

Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

Run don't walk from that doc. Prelex is the old Array "multifocal"
which will give you more than you want. For no extra charge, you get
some dandy halos, starbursts, and very compromised vision at all
distances. And you even get the risk of retinal detachment thrown in.
If you're willing to take that risk at this point (as opposed to waiting
until you actually develop cataracts, when taking that risk is worth it
for sure), I'd recommend what I got, which is the Tecnis lens, an
optically correct silicone lens that provides spectacular clarity. Try
monovision with contacts first, and find out how much undercorrection
you can stand in one eye, I'd guess about 1.00 max). If you go with
full distance in both eyes, you will require reading/computer glasses
for sure. If mono, you will probably need like some weak glasses for
some functions, but they won't be required. Make sure you go to a
surgeon who has done a lot of stitchless small incision work under only
local anesthesia, preferably one who specializes in cataract/lens
exchanges over one who "does it all". Good luck.

w.stacy, o.d.

xennie wrote:

>I went to a doctor yesterday to discuss lasik, & he steered me toward
>Prelex implanted lenses. He does both (as well as botox & laser
>dermabrasion: is that normal for an ophthalmologist's office?). His
>credentials seem impecable & he's been a surgeon for about 40 years
>(not young). I'm finding it impossible to get objective information
>about Prelex since everything I find on the net is written by surgeons
>who are selling it. I'm 45, have a -4.50 prescription, wear soft
>contacts, use reading glasses. He said it would be superior to lasik
>w/ monovision & my vision would be stable for life. He did say I'd see
>halos around lights. Anyone care to issue an opinion or suggest a
>source for objective information? Thanks in advance!
>
>
>

William Stacy wrote:
> Run don't walk from that doc. Prelex is the old Array "multifocal"

(snip)

Thanks! I would like an excuse to run: altering my eyes natually
scares me to death & I want to have as complete as possible confidence
in the doctor that I choose for lasik (likely I will have it done).
Actually the fact that his office did cosmetic procedures like botox
which are unrelated to ophthalmology made me uneasy.

And I appreciate the advice given in a previous post to try a contact
lens prescription that simulates monovision. Will do that first.

Posterior chamber implant surgery is serious business, especially for
someone who could achieve correction with a less invasive procedure.
Althought cataract surgery is one of the most often-performed
procedures, serious things can still happen.

If you can tolerate contact lenses, then stick with them. If you are
unable to wear contact lenses, then LASIK, LASEK, or PRK might be
viable alternatives for your prescription.

DrG

Then I gather you don't think LASIK is worth the risk simply for the
convenience of not needing to put in contacts every morning, or carry
boxes of disposable contacts w/ me when I leave for long vacations?

My answer is that the risks of a long-term vision problem are greater
for LASIK than for any contact lens. The question is: What is that
risk worth to you? It's not worth it to me.

DrG