Sugery and choosing an Ophthalmologist

[reina373]

I had Lasik done in 1999 and a detached retina in 2005. As a result of the detached retina I had a vitrectomy procedure in 2005.  Now, I need cataract surgery on my right eye and have been told by two doctors that their ability to estimate my idea power on my IOL lens will be difficult to be able to ascertain. They also indicated my case would be more difficult, given the prior surgeries I have had.  My vision was measured recently on the right -3.25+1.50 125, and on my left is -4.00+2.00x088.  The recommendation is to get a Toric Monofocal set for distance at plano.  By the way, I'm a young professional who does heavy computer work.

Now, I am just wondering which doctor would be best to go to. Both doctors that I have visited are board certified, however one is also certified by the Fellow of the American College of Surgeons and has been in practice 22 years. The doctor said, he would have someone else in the office do the exact calculations for my lens (an expert).

The other doctor is board certified but does not have the Fellow of the American College of Surgeons (F.A.C.S) certification, however, teaches at a leading university, been in practice 9 years, and is the director of the University's LASIK center. This doctor said she would be responsible of making the best educated guess on my lens order.   Is it important that I choose an ophthalmologist who is certified from the Fellow of the American College of Surgeons? I can also inquire on one of the rated Best Ophthalmologist for 2011.   Any suggestions on choosing an ophthalmologist for this  surgery?

[John C Hagan III, MD, FACS, FAAO]

1. Yes you can wear a progressive only on one eye.
2. The choice is yours and yours alone. I would hesitate to recommend monovision. Use the archives its discussed in great detail
3. Your chances of being independent of glasses are very small
4. Yes your expecations are too high.

JCH MD

[reina373]

Your points merit further investigation on my part.  So, if I have to wear a progressive no line bifocal on the operated eye; can they make glasses with one lens needing a bifocal and the other lens corrected for neartsightness?

Given my prescription, what refractive error post surgery would you recommend, so both my eyes work together?

Also, both doctors spoke about doing possibly doing some PRK on my left eye. One doctor measured the flap, and thought that it could be possible.   What are the possibilities of not being dependent on glasses given my situation, and that I had LASIK in 1999 already in both eyes?  

What would be realistic expectations? Are my expectations too high ?

Please advice.

Thanks,

[John C Hagan III, MD, FACS, FAAO]

I would get the opinion of both about the desired refractive error post surgery without glasses. If you go for plano at distance you may have trouble with your eyes working together. By "young" I am assuming you're younger than 40 and do not wear bifocals already. You understand that with a monofocal IOL you will have to wear a progressive no line bifocal on the operated eye don't you.

There are many many discussions about different "targets" post op when both eyes are to be operated on.  You are chosing "monofocal" pattern. Operated eye for distance (20 feet or more) of plano. your unoperated eye has a spherical equivalent of a -2.00 refractive error without glasses.

As to your question there were over 3.25 million cataract/IOL operations last year so most cataract surgeons are very skilled and experienced. I would go with the one you feel most comfortable with.

I am a Fellow in the American College of Surgeons but if both are Board Certified I don't think I would let that be the deciding factor.

JCHMD