Clear lens extraction - postoperative feedback wanted

Discussion in 'Optometry Archives' started by Wimbledon, Sep 3, 2006.

  1. Wimbledon

    Wimbledon Guest

    Need feedback from people who have had Clear Lens Extraction.

    I have been offered CLE in London UK for my myopia of approx -11 in
    both eyes with astigmatism in the range of ( 2 - 2.5). However, I would
    like some feedback from people who have actually undergone this
    procedure. How are your eyes now, any problems with retinal
    detachment, glaucoma, night driving etc. Having gone through this
    operation, would you still recommend it?
    Any advice you can give will be greatly appreciated.

    Helen from London
     
    Wimbledon, Sep 3, 2006
    #1
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  2. Not sure you'll get much reply, as few have been done. I've tried to
    push a few hyperopic patients into it, only to have the surgeons chicken
    out. With your high myopia, you'd want the very best and the very best
    might not go for it due to the relatively high risk of retinal
    detachment. In the US the insurors are probably freaking out about this.

    Anyway, make sure there's a retina surgeon on call in your area when you
    go in, and be sure to let us know the results here if you do go through
    with it.

    Good luck.

    w.stacy, o.d.

    (You didn't give us your age, but if I had your Rx and was over the age
    of 45 or so, I'd go for it)
     
    William Stacy, Sep 4, 2006
    #2
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  3. btw, I have had the same procedure although I was developing cataracts,
    was myopic and astigmatic. Had a great result, but did not have and do
    NOT recommend multifocal or "focusing" IOLs under any circumstances.

    w.stacy, o.d.
     
    William Stacy, Sep 4, 2006
    #3
  4. Because the multifocals are bad optics. More than 50% of the light
    entering your eye will be OUT OF FOCUS no matter what the viewing
    distance. Forget it. Instead, choose the best distance for you and go
    for that distance.

    Yes, I had lost my accommodation, but I knew the problems associated
    with tiny multifocal optics, since I've been in the business all my
    life. I opted for single vision lenses (prolate, of course) and am
    thrilled with my vision.

    If you get IOLs you WILL NOT HAVE ACCOMMODATION no matter what the
    surgeon says. Tell him/her you want the best optics you can get at the
    "name your distance" distance, and go from there. You will want glasses
    after surgery, but far less than you need them now.

    w.stacy, o.d.
     
    William Stacy, Sep 4, 2006
    #4
  5. Not much. Since you're used to monovision, and assuming your good eye
    is emmetropic and 20/20, I'd probably recommend a full 2D. myopia post
    op target. This also assumes the bad eye corrects to 20/20. If not,
    just shoot for a very mild myopia (.50) to allow for some hyperopic
    error. A multifocal will indeed allow some reading, but who want's bad
    optics at ALL distances, which is what they give?

    w.stacy, o.d.
     
    William Stacy, Sep 4, 2006
    #5
  6. sdavies6 wrote:

    I would probably spring for the cost of a custom fit
    Sorry about the confusion. My advice still stands. Avoid bad optics.
    Avoid multifcal IOLs. You don't exactly "try out" an IOL. It's
    permanent and the surgeon will not explant it without a serious problem,
    and your vision complaint probably would not qualify.
    Another bad idea. If you have a small residual error, what is wrong
    with glasses to correct it? I'd never consider having Lasik for such a
    reason. You've been wearing what, -13 or so for years and you're worried
    about maybe wearing a 1 or 2 diopter lens????

    w.stacy, o.d.
     
    William Stacy, Sep 4, 2006
    #6
  7. I said:

    You don't exactly "try out" an IOL.

    having missed the multifocal CONTACT LENS trial idea. You could do
    that, but I've also never seen a multifocal contact lens that I liked,
    and one in your Rx (-13 or so?) probably isn't even made...

    The problem with the optics of multifocal contact is the same as with
    the mf iols. You have more than half the light entering your eye being
    out of focus at any particular viewing distance. Now that's my idea of
    a bad optical situation. There is no theoretical or practical way
    around it that I know of.

    w.stacy, o.d.
     
    William Stacy, Sep 5, 2006
    #7
  8. So I take it you are presently correctible to 20/20 in both eyes and
    have a monovision contact lens (probably around -2.00 over-refraction)?

    If so, then my advice is still to shoot for exactly what you now have.

    Which begs the question. Why ARE you considering all this? Do you have
    a problem with your contact lens?

    w.stacy, o.d.
     
    William Stacy, Sep 5, 2006
    #8
  9. I'd want to know exactly how much and why not. Ask the tough questions.

    I tolerate the lens and I'm OK with my present vision.
    I thought you were going monovision. If you are wearing + 2 readers,
    then why haven't they tried a full power lens on that bad eye? At the
    very least you need a careful sphero-cylindrical over-refraction while
    wearing a known lens with decent optics, like maybe a Night and Day.

    You got that right. My new rule for myopes: before going into iol
    surgery for any reason, have a full 360 degree peripheral retinal exam
    WITH scleral indentation all the way around. It's not all that
    uncomfortable and is good insurance. Plus if and when you do go in,
    make sure there's a retinologist on call in your town at the time of the
    surgery.

    w.stacy, o.d.
     
    William Stacy, Sep 5, 2006
    #9
  10. If you're talking about a translating lens (one that is designed to move
    forward and aft), you're almost correct. It would be impossible to
    make, not difficult. You can't move a weak lens far enough to get a
    significant refractive shift in the human eye. Not enough room. But
    what the heck, even strong lenses aren't moving enough to amount to
    anything. They've got a long way to go to get a truly focussing iol.
    Maybe you have short eyes? Could be that either your corneas are very
    steep, or that your old crystalline lenses were very strong. Could also
    be that the card was wrong. Or any combination of those 3 factors.

    w.stacy, o.d.
     
    William Stacy, Sep 5, 2006
    #10
  11. Wimbledon

    Ace Guest

    I agree with William Stacy. There is *no* point getting lasik after
    getting CLE or cateract surgury. Lasik is another un-neccessary surgury
    that carries additional risks and you will still need glasses either
    way. To sdavies6, before choosing the power of your IOL, try it out
    with contacts first. How much of an undercorrection do you want? Youve
    been wearing -12 contact which slightly undercorrects you. Try a -11
    contact and see if you like the idea of monovision. If you choose
    distance, still ask for a -.5 diopter undercorrection to decrease the
    risk of *overcorrection* which will make things blurry at *all*
    distances then you will be *very* unhappy.

    I still say stick to your contact lens as long as possible, you seem
    picky about your vision and unsure about the idea and risks of IOL(s)
     
    Ace, Sep 5, 2006
    #11
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