Your contacts sound excellent.  I really miss the great (uncorrected) near vision I had with moderately high myopia.  Now everything within arm's length is blurry.  Are your contacts gas perm or soft?

The Australian lenses I ordered might also work well for you.  They can correct astigmatism, and they're made from the same material as Extreme H20 soft contacts--so they're reportedly comfortable even for dry eyes.

Hi Jodie,
I Hope you are still looking for an answer from me.  Have been out of town.  Will check with the eye doc I've seen for 30+ years as to the brand of bifocal contacts I wore (and still wear in my unoperated eye)for the last 10 years.  Will let you know the brand. I initially noticed a SLIGHT decrease in distance vision with them versus straight distance vision lenses, but I enjoyed seeing up close so much I soon became hooked on them. I could read everything with no readers, however, if it was like a long book would wear the readers to enhance the close up vision.  I do know they were/are expensive and had to change them every couple of years due to warpage.I would like to know how your Australian contacts work out.

I've never worn bifocal contacts before.  What brand of contacts have you been wearing?  Of all the disposable ones I tried recently, the best were C-vue multifocals in plano and +.25, both with a high add.  (I was -5.50 D with 1.50 D of astigmatism before cataract development/surgery.)  My near/intermediate vision with these lenses is all right.  However, it's obvious how much better my distance vision becomes after I remove the lenses, so I haven't been wearing them much.  I know it's "politically incorrect" to say it, but I really don't want to compromise with my vision.  So I ordered a pair of Triton translating soft bifocal lenses from an Australian manufacturer (Gelflex Labs).  They promise "uncompromised" vision at all distances--I'll pay whatever they cost if they actually work for me.

I thought it was LASIK (not PRK) that's contraindicated for thin corneas, but I might be wrong.

Hi Jodie,
The correction I quoted is POST cataract surgery. Before surgery my correction was -7.7with about 3.75 of astigmatism.  So you can see I am much better.  But because I still have over 2 of astigmatism and -2 of nearsightedness things are still blurry.
I will check out the PRK.  I have pretty thin corneas and originally was told I could not have it so think that is probably still the case.  Am curious.....what is your correction now and are you able to wear the bifocal contacts?  I wore them for years and liked them.  Mintha

In answer to your questions...I have already had cataract surgery with limbal relaxing incisions in one eye. I had chosen a Crystalens hoping I would get some intermediate and possible a little near vision with it (if it worked). I knew I would mourn the loss of my close up vision (which I really have) Since the surgery my distance vision in the operated eye is good, I think I may have some intermediate vision, which seems to come and go, but don't think I have any close up vision left. My other eye has a cataract in it which will eventually need surgery, but for now am enjoying my bifocal contact in it and the ability to see up very close with it when the contact is off. I think until I have the LASIK (in the eye that had surgery) (to correct the left over astigmatism and nearsightedness) I will not know for sure if the Crystalens was a bad or good decision. The jury is still out. If I am not happy with it may not opt for it in the second eye. I don't know what my choices will be.I really appreciate being able to "talk" with you.

A doctor recently posted that the Crystalens provides the best intermediate vision of the three premium lenses.  You don't have much of a correction in that eye--are you currently wearing a toric contact?

When I was looking into methods of astigmatism reduction (before deciding on LRI's) my surgeon recommended PRK over LASIK.  He told me that PRK takes longer to heal but is much less likely to cause dry eyes (a concern of mine because I intended to wear bifocal contacts post-cataract surgery.)  He told me that either procedure would yield good results, and tho cost of both was the same.  Have you considered PRK?

Thanks for your reply and to the reply from O.D. about "AK" incisions.  In answer to your question,my goal is to try to come
as close to not having to wear contacts or glasses as possible. I have been severely nearsighted since around 9 years of age and have worn contacts successfully for almost 50 years. However with increasing dry eyes and glasses being uncomfortable, I would like to see if I could get as close to plano as possible.I do a lot of work that requires intermediate vision.  I am ok with having to wear reading glasses. So after much research and reading this column for months I felt my best option
to achieve this was an accomodating lens. Yes, I know there are those who don't like this lens, but I wanted to try it. My surgeon made it very clear to me that I would need LASIK afterward to get me further to my goal. I probably will forget
about the AK as it sounds unreliable....it had just been brought up by another surgeon as HE felt it had a few advantages using it to further zap the astigmatism before LASIK.  I do like my original surgeon but went to get another opinion as the second surgeon does a lot more LASIK than the first. I will make sure my eye is healed properly from everything before proceeding with the LASIK.

I'm not sure I understand your situation.  Are you saying that you had catarct surgery on one eye, which eliminated much of your myopia and astigmatism...and now you want to get an accomodating lens for your second eye?  Will you be doing LASIK then on both eyes?   Have you considered monovision or modified monovision instead of the Crystalens?

I had to smile at your reference to "perfect" vision.  I'm also a former high myope with astigmatism.  Recebt cataract surgery and LRI's gave me 20/20 vision for distance, but it's sure not what I'd call perfect vision.  My near and intermediate vision are now so blurry that I'm very uncomfortable without glasses/contacts in most situations.

I researched methods of astigmatism reduction before I had cataract surgery.  I read that AK can produce severe night aberrations, including halos and starbursts.  LRI's are reported to involve less risk of a bad outcome, and they are used more frequently today than AK.  (But LRI's are unreliable and reduce astigmatism by only about 50% on average.)  Laser vision correction (LASIK, PRK) is supposed to be the most reliable method to correct astigmatism.

I'm curious--is there a specific reason why you need "perfect" distance vision?  (You'll still need glasses or contacts for clear near/intermediate vision.)  And why even consider having two procedures (AK and then LASIK) when just LASIK would do the job?  The more procedures you have, the higher the risk (and the cost).  Why not give your eyes time to completely heal and then reevaluate your goals?

http://www.dohenylaser.com/index.php?id=20

its a form of keratotomy.  surgeons used to do this all the time...it was called "RK" or readial keratotomy and made patients less nearsighted.  no one does that in the US anymore (RK, that is).

but AK is still around for cases like yours.  its a little unpredictable as to how much astigmatism it does/does not correct.  its kind of an "art"...not nearly as scientific as say LASIK, but AK is one of the only things available for refractive procedures in certain high-astigmatism Rx's....