Refractive lens exchange vs. LASIK post-cataract surgery

Discussion in 'Laser Eye Surgery' started by Jane, Jun 22, 2006.

  1. Jane

    Jane Guest

    I am a 54-year-old woman with symptoms of a cataract in my right eye,
    resulting from a vitrectomy and epiretinal peel last January (which
    restored my corrected vision to 20/15!) Both eyes have moderate/severe
    myopia with astigmatism (OS/OD -5.50 -1.50 x180 +2.00 add). The
    cataract surgeon I consulted agreed to my plan of implanting an
    aspheric IOL (with astigmatism incisions) in that eye, which leads to
    the dilemma of what to do with my eye that shows no signs of cataract.
    My choices seem to be: (1) continuously wearing a contact lens in my
    left eye; (2) some type of laser surgery; (3) refractive lens exchange;
    (4) an implantable contact lens plus astigmatism correction. I'm
    hoping to avoid an outcome that leaves me with worse vision/new
    problems, yet I can't imagine wearing a contact lens continuously for
    the next 10-15+ years.

    There's also the issue of my vision goal for surgery. I was thinking
    of aiming for mild myopia in both eyes (-.5D? -.75D? -1.00D?), hoping
    that I could sometimes function without glasses/bifocal contacts. Does
    this make sense? I'm also concerned about the accuracy of my
    pre-cataract surgery measurements, especially given my history of
    vitrectomy. Would I seem like a nut case if I requested that they be
    done twice (or using two different methods?) I currently wear toric
    contacts/reading glasses but want to try Triton bifocal soft lenses
    post-surgery for near/intermediate vision correction. (Monovision
    doesn't work for me.)

    I have technical information about my choices, but would appreciate all
    input based on real life experience.
    Jane, Jun 22, 2006
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  2. I agree with #1 first, but disagree with even considering lasik or prk.
    I think at her age, doing a refractive lens exchange makes a lot of
    sense, after her peripheral retina has been checked thoroughly by a
    retinologist to address any risk of detachment. This of course assumes a
    very nice outcome of the first eye.

    I also agree with shooting for a mild myopia, around -.5 on the first
    eye, and after evaluating the final outcome, decide on the other eye target.

    w.stacy, o.d.
    William Stacy, Jun 22, 2006
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