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Laser Capsulotomy
About six months ago (February and March, 2015) at age 80 I underwent cataract surgery on both eyes. About a month afterwards my doctor recommended that I undergo laser capsulotomy for posterior capsule opacification in both eyes. I have two questions related to this procedure, but, first, I wish to submit some background information on the cataract surgery and its results.
After implantation of a "far-distance" IOL (toric) in the left eye, I agreed to use the monovision technique. Residual astigmatism in both eyes after surgery was zero. Optical power corrections needed are -0.50 diopter for the left eye (for viewing objects at 20+ ft) and -0.25 for the right one (for reading at 18 in). A correction of +1.50 is needed for the left eye to view near objects, and -2.50 is needed for the right one to view far objects. Corrected visual acuity six months after surgery was about 20/30 for the left eye and J2 (at 15 in) for the right eye.
Questions: (1) Would capsulotomy tend to decrease refraction within the eye (increase focal length) and thereby reduce the amount of negative correction presently needed? (2) Would you suggest that I undergo surgery on the left eye in the near future and defer it for the right one -- or, would you suggest that surgery be performed on both eyes in the near future during one session?
Postscript: Overall, I believe that monovision was a good choice. Throughout most of a typical day I do not wear eyeglasses. Although the effects of anisometropia and loss of accommodation are noticeable, they go unnoticed most of the time. They are most pronounced when viewing TV and when driving. (I sometimes tend to close my right eye to improve acuity when viewing TV without glasses, and close my left eye when viewing with glasses.)
After implantation of a "far-distance" IOL (toric) in the left eye, I agreed to use the monovision technique. Residual astigmatism in both eyes after surgery was zero. Optical power corrections needed are -0.50 diopter for the left eye (for viewing objects at 20+ ft) and -0.25 for the right one (for reading at 18 in). A correction of +1.50 is needed for the left eye to view near objects, and -2.50 is needed for the right one to view far objects. Corrected visual acuity six months after surgery was about 20/30 for the left eye and J2 (at 15 in) for the right eye.
Questions: (1) Would capsulotomy tend to decrease refraction within the eye (increase focal length) and thereby reduce the amount of negative correction presently needed? (2) Would you suggest that I undergo surgery on the left eye in the near future and defer it for the right one -- or, would you suggest that surgery be performed on both eyes in the near future during one session?
Postscript: Overall, I believe that monovision was a good choice. Throughout most of a typical day I do not wear eyeglasses. Although the effects of anisometropia and loss of accommodation are noticeable, they go unnoticed most of the time. They are most pronounced when viewing TV and when driving. (I sometimes tend to close my right eye to improve acuity when viewing TV without glasses, and close my left eye when viewing with glasses.)
Note: Right eye lenses in my distance eyeglasses and readers are -2.50 and -0.25, respectively.
1. Aw shucks, I was hoping that the removal of capsule cells would result in less overall refraction.
2. Glare is not a problem, and blurred vision does not seem to be a problem (if my understanding of the term is correct). Unless I can be convinced that continued deferment of the procedure would be detrimental, I am inclined to delay it. Many thanks for your helpful comments.
1. Aw shucks, I was hoping that the removal of capsule cells would result in less overall refraction.
2. Glare is not a problem, and blurred vision does not seem to be a problem (if my understanding of the term is correct). Unless I can be convinced that continued deferment of the procedure would be detrimental, I am inclined to delay it. Many thanks for your helpful comments.
Note: I am going to assume you made an error in your send sentence and your distance RX in the RE is -2.50 Otherwise your glasses RX for distance doesn't make sense if it really is -0.25.
1. A Yag capsulotomy would not be expected to change your glasses RX.
2. The decision to have Yag capsulotomy is based on a. having a cloudy posterior capsule and b. that it is cloudy enough to cause visual difficulties to the patient. So you should have some complaint about blurred vision or glare to justify the procedure.
JCH MD
1. A Yag capsulotomy would not be expected to change your glasses RX.
2. The decision to have Yag capsulotomy is based on a. having a cloudy posterior capsule and b. that it is cloudy enough to cause visual difficulties to the patient. So you should have some complaint about blurred vision or glare to justify the procedure.
JCH MD
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