Accomidating IOL

[Runner2008]

I was born with a congenital cataract, which I had removed 20 years ago at 3 months old. Since then, I've been wearing a soft contact lens in that eye to make-up for the focusing power of the removed lens. Anyways, I have been considering getting an intraocular lens in place of the contact lens. My question is whether or not I would be able to get an accomidating IOL like the Crystalens, since the surgery was so long ago and occured when I was so young.

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

The cataractof the infant is much different than an adult and the surgery is much different also. It is so soft that it is generally sucked out rather than pulverized with ultrasound like an adult. Also the eye is much more inflammed afterward and the back capsule always clouds over so that now an opening is always put in the posterior capsule.

This inflammatory reaction often scars the iris to the part of the lens left in the eye to hold the vitreous back. Also some of the soft part "cortex" often remains and forms a tiny white donut like body called a Sommering's Ring.  Bottom line your pupil problem is quite common.

Only an exam can tell you for sure but I think it highly unlikely that surgery would restore the type of pupil you want one that moves and matches the other eye.  The procedure you're talking about is for some one that has had a sector iridectomy and the pupil migrates to the very top of the eye. The "pupil" formed with that operation isn't normal it's just more in the center of the eye. It doesn't move.

JCH III MD

[Runner2008]

Thanks for the help. I have one final, and somewhat unrelated question for you. When I had my congenital cataract removed, afterwards there was some scar tissue formation and thus even though the iris does dialate and contract somewhat, the pupil in that eye is much smaller and irregularly shaped compared to my other eye's. My question is, are there any surgeries at all that could make my pupil more normal in size and shape? I've one some research on this and found what's called a iridocystectomy and was wondering if maybe this would be a possibility. Thanks in advance for the help, I do really appreciate it.

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

They are not all the same and have many important differences. On this forum and in the medical literature there are many more unhappy patients with ReZoom IOLs. Moreover at a surgical meeting here in Kansas City out of a poll of 200 eye surgeons none would have ReZoom put in both eyes and very few would consider one in their eyes.

The multifocal Crystalens and ReStor are more expensive, have a greater chance of complications, will have worse night vision, have more of a chance of having to be removed and you may still need glasses from 20-80% of the time.

JCH III MD

[Runner2008]

Why wouldn't I consider the ReZoom IOL Only Crystalens or ReStor or high quality aspheric monofocal? Are they not good IOLs, or would they just not work for my case?

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

Only an eye exam by a Eye MD refractive surgeon can tell for sure. Do not even consider the ReZoom IOL Only Crystalens or ReStor or high quality aspheric monofocal.

JCH II MD