Avatar universal

IOL lemses transpalnt

Dear Madam/Sir,

I am 35 years old. Around the age of 27 I had a LASIK surgery.
• I could never wear glasses because of very strong headaches. This is due to the reason that my brain could never compensate the perception differences.
• Before the LASIK surgery I used to wear soft contact lenses and it was excelent!
I had 6/6 on my right eye and 6/9 on my left. Unfortunately I become allergic to the preservative materials and I had to stop wearing them.

I will describe my medical eyes situation:

Before the surgery:
-5 cylinder (astigmatism) on the left eye
-2 cylinder on the right.
I was farsighted as well.

After the surgery:
I have today:
+1.8 in both eyes
-2 cylinder in both eye.
I can function today but I feel that it is hard for me to read and to sit in front of a computer for a long time. I am an engineer and I need to read a lot.

• Recently the doctor and the optometrist tried to help me with RGP contact lenses. I tried them for two month and it was unbearable. I could never adjust to the friction between the cornea and the lens.

I will present my questions:
1. Is it possible to transplant an artificial intraocular lens (IOL) to a person in low number as myself?
2. I very, very worried about the fact that I am already farsighted and around the age of 40 or 45 there is persbyopia problem and I will need reading glasses. I that age I will not be able to see anything and I cannot fix it.
Is it possible to transplant artificial intraocular lens (IOL) in order to solve this situation?
3. Can I carry out an eye exercises in order to practice my eyes make more focus?

Thank you in advance for your kind help,
2 Responses
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Avatar universal
Have you tried wearing glasses with the prescription +1.75  -2  x whatever?  This should greatly help your current vision problems.  (Based on your post, I'm guessing that aniseikonia prevented you from wearing glasses before you had LASIK.  But this should not be the case now.)  When you develop presbyopia, you could switch to a multifocal and have excellent vision at all distances.  (Did you know that people wearing glasses are perceived as being more intelligent than people who are not?  This is why it's sometimes advised to wear glasses --rather than contacts-- to a job interview.)
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Avatar universal
Hello ron  There are some options that might be considered. I can only list them and not tell you whether they are appropriate to your case.

1. Intraocular contact lens. This is a lens put inside the eye in front of your natural lens. Risks include infection, bleeding and cataract formation. I personally don't recommend this for my patients but some surgeons claim very good results and happy patients.

2. Clear lens extraction. Here your lens is removed even though it doesn't have a catract and an implant is put in your eye either a monofocal implant or a multifocal implant. This involves all the risks of regualr cataract surgery and generally you will have to wear no-line bifocals to have the best vision in both eyes at all distances. Same comment from me as above. There are also toric implants that correct for astigmatism. This is a rapidly evolving field and many improvements are likely to occur in the next few years.

3. You might see a ophthalmologist that specializes in refractive surgery only. Many of these have experience in dealing with patients that have had RK, CK, LASIK, LASEK with unsatisfactory results.

4. There's no reason to expect that you would not be able to adjust to progressive bifocals as you grow older if you don't opt for any surgical options.

5. Eye exercises are generally not helpful at all.  So called "Visual Therapy" is very expensive and unproven for benefit. Presbyopia is not due to weak focus muscles but due to the human lens getting stiff and thicker as we get older (like a tree trunk grows from a supple sappling to a rigid tree).

6. For completness sake I will mention the possibility of doing refractive arcuate incisions on your cornea to try and reduce or eliminate the astigmatism.

You can use the website of the American Academy of Ophtal mology   www.aao.org to find a refractive surgeon in your geographic area.

JCH MD Eye Physician & Surgeon
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