Does clear lens extraction give better vision than contact lenses?

I am 49 and have severe myopia (greater than -21 in both eyes) and my
vision cannot be totally corrected with just contact lenses. Would
anybody be able to tell me whether or not procedures such as clear
lens extraction produce better vision than contact lenses?? would such
a procedure improve my vision? I am currently unable to see well
enough to drive, would such a procedure produce the slight improvement
needed for this?

Thanks, i really would appreciate some feedback.

 

I'd suggest you consult with your eye doctor who would be in a better
position to understand the underlying causes of your decreased
acuity---optical vs physiological or neurological. It is indeed
*possible* that CLE (perhaps with an ICL or contact lens to correct the
residual refractive error) would improve your vision.

You would be wise to ignore replies from people who are not
professionals in the field or who have not experienced the procedure as
someone in your situation and with similar history.

--LB

--
Dr. Larry Bickford, O.D.
Family Practice Eye Health & Vision Care

The Eyecare Connection
http//www.eyecarecontacts.com
larrydoc at eye-care-contacts dot com (remove -)

 

Dear Alice,

Of course you should see the ophthalmologist who
would do the operation.

By using ultra-sound and other measurement techniques
he can tell you if your suggestion is feasible.

FYI:

The Gollstrand Schematic eye lists
the power of the lens as:

19.11 diopters (un-accommodated) and 33.06 diopters accommodated

(Standard young eye.)

Best,

Otis
Engineer

 

Thanks for your response Larry! I also have astigmatism and my left eye is a
lazy eye, could this be why my vision can't be corrected fully with
contacts? If this is the case would CLE be able to improve things?



I have heard that there is a risk of retinal detachment with the procedure
would you be able to give me any indication of how serious this risk
actually is?



Sorry for all the questions, I just want to find out as much about it as I
can before I pay for a consultation. I live in the UK, do you know of any
good specialists based over here?



Thanks again....



Alice

 

Yes, one possible reason.

No, not likely a fix for "lazy eye" and the astigmatism, and any
remaining refractive error would have to corrected with a contact lens
or a cornea refractive surgery.

It is generally a small risk, especially compared to the
benefit----however, the risk is related to factors which your surgeon
may be able to determine before proceeding.

I don't, but hopefully you'll hear from someone else who can offer you a
referral.

You are welcome and good luck with your decision.

-LB

--
Dr. Larry Bickford, O.D.
Family Practice Eye Health & Vision Care

The Eyecare Connection
http//www.eyecarecontacts.com
larrydoc at eye-care-contacts dot com (remove -)

 

Alice,
I too am a -21 myope in my 40's and have been considering the exact same
questions you have. I recently spent some time in a med school library
lookking through the past few years of the Journal of Corneal &
Refractive Surgery, where a lot of these issues are being addressed. Any
CLE/cataract surgery has some risk of RD and the gerneral consensus
seems to be that the longer the ocular axial length, which is often
directly related to the degree of myopia, the greater the risk of RD. I
saw a table in a recent article that summarized several studies and the
RD incidence ranged from 0 to 8%. Most researchers feel that the single
biggest risk factor is whether an Nd-YAG preocedure is needed in the
event of posterior capsule opacification. When the capsule is opened by
this procedure, the vitreous can move forward and essentially pull on
the retina, possibly resulting in a detachment. Groups are noting that
removing all residual lens material may reduce the rate of PCO, as can
the use of certain materials and shapes of implanted IOL's.

My mother has essentially the same ocular conditions I have and had
cataract removal done 20 years ago when she was in her mid-40's. They
did almost did everything they could to increase her risk of RD
(unwittingly) in that no IOL was used (no need for refractive purposes)
and a NdYAG capsulotomy was performed. She never had any issues. Her
vision improved somewhat after the surgery in that she no longer had
image-size reduction caused by the previously necessary high degree of
refraction, but 20/25 was the best she could get. There is usually too
much macular stretching to get 20/20 for very high myopes.

Personally, I'm waiting until cataracts give me no choice. I hate the
situation I'm in now, but if an RD happened after an elective CLE... I'm
hoping that time will bring about new insight into the problem, plus age
is actually a benefit as risk sems to decrease with age due to changes
in the vitreous. Age-related vitreous changes usually mean less "grip"
on the retina.

Johnny

 

You've done your research well, Johnny. Both of you should keep in mind
(and I understand you appreciate this fact) that, surgery or not, you
are greater risk for RD in any event.

Another issue to consider is that researchers are developing another
procedure which looks interesting, if not promising. That is, the
removal of the lens nucleus and replacing it with either an implanted
mini-lens or a optical gel to correct the optics. If this works in real
people, the surgical risk for RD due to vitreous traction is removed
from the picture, although the overall risk for axial myopes is not and
we dont know yet what other risks might be introduced by the new
procedure.

I do not believe that the implantable contact lens designs (anterior or
posterior chamber) are currently available in powers to address your
needs and I'm not certain the risk/benefit profile would be much
different.

Regards,

LB

--
Dr. Larry Bickford, O.D.
Family Practice Eye Health & Vision Care

The Eyecare Connection
http//www.eyecarecontacts.com
larrydoc at eye-care-contacts dot com (remove -)