Intraocular lens implants

[Golflady13]

Between the ages of 7 - 12 I had lots of cataract surgery. I now have lots of complications because of this and I am now 44. I have glaucoma which I see a consultant for and also see a retinal consultant to make sure no problems develop there. My retinal consultant just referred me to another consultant who specialises in squints and IOL's as he believed I would be a candidate for both of these procedures. It was suggested at referral that I have botox to cure my squint but the new consultant has suggested surgery which I'm fine with but don't fully understand why this over botox? Also at the new consultation I was turned down for IOL's because of my previous cataract surgery but the retinal consultant seemed convinced I could have this procedure with lenses fixed in front of the lens capsule?

I am wondering if I should get a second opinion?

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

Good luck. Get all the answers and understand the choices, the risks, etc before signing on the dotted line.
JCHMD

[Golflady13]

Hi John, Thank you again! Until 2 months ago I hadn't been offered anything since age 13 and then to have everything promised is quite overwhelming, especially when taken away again as quickly.

My retinal consultant suggested and referred me for an IOL in front of my existing aphakic lenses but the strabismus consultant only considered posterior?? I don't know why and I never questioned due to nerves so now I have looked into this more I will go back and hopefully get an answer to this.

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

You should ask your glaucoma eye MD about this proposed surgery.  If you go thorough with it with eyes wide open to the possible complications you would do well to avoid "premium" IOLs like  ReStor and CrystalLens and stick with monofocal.

Also if you do not have enough remaining posterior capsule to support the IOL then you may have to have scleral sutures which also make the operation more difficult.

Look, look, look before you leap

JCH MD

[Golflady13]

Thank you I will get some more advice regarding strabismus surgery. Are you aware of any IOL'S that may be suitable and safe for my eyes. I have been prescribed drops for glaucoma for a number of years which dry my eyes out ( I use a lot of fake tear eye drops) and wearing a contact lens is mostly uncomfortable. I have to wear a c lens plus glasses for distance or reading as this gives me best vision. The IOL's would potentially replace my c lens therefore stopping the dry eye discomfort.

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

This is a very very complex situation with the potential for many complications. I would get a second and third opinion. Botox is temporary and inexact treatment for squint (really called strabismus)  It has some applications but not in an adult like you.

JCHMD