cataract surgery after lasik

[gerlad1]

I posted a couple of months ago--I am 67 and had lasik about 9 years ago. With advice from surgeon,, (since I had mono-with left eye for reading/ right eye for distance with prior lasik) for cataract surgery opted to go with mono again with toric iol.  Surgeon replaced left lens with toric (allegedly for reading/computer work) and plan to do right eye for distance next month. However, 3 weeks post surgery, I find that my left eye focal length is such that things are clear about 6 inches from my face. Reading is good, but requires me holding paper a few inches from my face.  Computer screen and reading on desk is blurry at best.  Am I stuck with this in this eye? or is it possible/advisable to replace the lens in this left eye with a different lens? or is lasik in this eye and option?
Thanks,
Gerald

[gerlad1]

Went to original surgeon,, he acklowdges that I am now very nearsighted--5 weeks after cataract surgery.
He proposed swapping out the IOL with a toric with "correct" focal length--says this is a very low risk surgery.  He recommended against PRK.
Should I be concerned? If so, what about?  Apparently, financially,,I appear to be getting a "warranty job".
thanks,
Gerald

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

1. Once the eye is healed say 3 months post lasik most surgeons do not object to contacts
2. PRK is surface lasik there is no flap raised. It can be done on thinner corneas or on eyes that have had lasik previously without making the cornea unstable
3. Swapping out the IOL is the highest risk most expensive option.
4. If you're stuck you can always get a second opinion

JCH MD

[gerlad1]

Is there any problems with using contacts after having lasik?  I am referring to the possible movement/dislodgment of the flap?
Additionally, I assume that PRK is different that "regular lasik" is this correct?
Also, I assume from your response that swapping out the IOL lens is not a good option. Correct?
Thanks for your help.
Gerald

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

First of all we've said many times choosing a IOL power to leave a person at a desired refractive error is not an exact science and the standard error is plus or minus .50 diopters. With lasier its .25 to .50 higher and with RK .75 to 1 diopter plus/minus

Your description indicates your over myopic and your focal point is closer than you would like.  You will need to discuss your options with your surgeon. Perhaps get a second opinion. Your options include glasses, contact on one eye or refractive surgery on surface of eye (PRK) if your cornea is still thick enough. Worst would be IOL exchange

JCH MD