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IOL's for astigmatism
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IOL's for astigmatism

I am scheduled for cataract surgery next month with Dr. James P. GIlls Jr. in Tarpon Springs Fl. I was unaware I had cataracts, just complaints of blurred vision in my right, non-dominant eye. I thought my prescription needed adjustment. Now I realize my overall vision in my right eye is cloudy from the cataract. I am wondering which IOL would be right for me. (Aren't we all?).
I have worn glasses since age 8, so the thought of going eyeglass free is tantalizing. While my Doc has great credentials, I wonder about the IOL decision. It sounds like docs specialize in maybe one or 2 types of lenses, so I wonder if the decision is based on the doc's comfort with the lens and procedure, or how many trips to Aruba the doc and spouse got from the lens company rep. (Rather cynical, I know, but I'm in the car business and in Florida, where corruption and influence peddling have been refined to high art).

I am 55, diabetic, glucose controlled, with no retinopathy.

My script: R: sp  -3.00  cyl -1.00  axis 10

           L: sp  -.75   cyl -2.50  axis 180

           OU +2.25.

I do mostly computer work, lots of driving. I spend hours a day peering over someone's shoulder at a monitor while I train them.

SO: What are the right questions to ask my docs?
(one does the surgery, and the other ("eye physician") does the follow up care.)

What's the best choice in an IOL?

How can you find their success rate, and complaint rate stats?

Florida DOH has NO complaints or disciplinary actions against either.

Thanks in advance for any advice-CitizenKen

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Avatar_n_tn
there is no "best choice" in IOL.  thats like asking "whats the best car?"  your case does not seem particularly unique or difficult.

there is not a way to find surgeon success rates, complaints, etc.  not that i know of, anyway...

tell the surgeon exactly what you posted here and see what they recommend for you.  thats really all you can do...
9 Comments
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Avatar_n_tn
This decision is such a personal one.  So many factors play into choosing the right lens for you.  First and far most, get the best refractive surgeon possible!! I believe that the multifocal IOLs have  sites that recommends docs in the different states to do their lenses.
Then make a list of what is important to you.  For me, having never worn glasses in my life, I hated the thought of starting now.  So, I went with the possibility of night abberations to avoid the glasses.  But since your have worn glasses all your life, do you want to risk the possible night abberations with the multifocal lens to avoid wearing glasses, when you have worn them your whole life? You said that you do a lot of driving.  Do you do a lot of night driving?  That could be a hugh problem with a multifocal lens.  I do not do a lot of night driving and I am very happy with my Rezoom lens.  However, if I did a lot of night driving, I would have gone with a traditional lens and forced to wear glasses.  So, the decision has to be what is most important to you.  To me it was not wearing glasses and living with the night abberations.  But this would not be acceptable for everyone.  Research as much as you can about the lenses and decide what is most important to you.   Best of luck!  Hard decision I know!!!
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Avatar_n_tn
Dr Gills is very experienced, and very principled. I would go with his suggestion. Multifocals might be a good choice for you, but the amount of astigmatism makes things more complicated. You would more than likely need multiple surgeries to achieve the greatest spectacle freedom, if that is your goal. If you don't mind wearing glasses for some tasks, a monofocal Toric implant such as the Alcon AcrySof Toric would be a great choice. The other Toric implant available from Staar has not produced consistent outcomes because it is built on a silicone plate design that does not hold its position in the eye very well.
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Avatar_n_tn
Thanks everyone for your generous comments. I'll schedule a pre surg appointment, and get my questions answered by the doc. If it's a choice between lowest incidence of side effects, and wearing specs, I'm going with the specs. Dr. Gills proffessional cred is impeccable, in fact he just lectured at Vanderbilt.

And the best car is is an Acura 3.2 TL (type R if you enjoy pulling g's through the corners).. ;-)...thanks again, everybody-Ken
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Avatar_n_tn
hahahahahaha  Your welcome!  And thanks for the info. :-)
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Avatar_n_tn
I have a deal for you--I'll get you an appointment with my eye surgeon up here in Georgia, if you'll get me one of those cars! (Your doctor in Florida is pretty well known though so you will do fine.)
I had an astigmatism too and my surgeon corrected it with the IOL. However ,for about two weeks my vision was a little funny when I was using both eyes. But that cleared up in a short time.I still wear glasses with a correction of 20-20  in my left eye and 20-25 in my right eye which had had a vitrectomy for a macular hole.Got great results .I can also recommend  that you take Ocuvite Preservision--it's a supplement
which is very good for your vision and I am convinced that my taking it was a factor in my healing so well with each surgery.Look it up on the internet.
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Avatar_n_tn
I agree with Hud... you have quite a bit of astigmatism in your left eye. although that is your refraction. It may mean that it is all "lenticular" astigmatism as opposed to "corneal" astigmatism. Will be important to know which kind it is, espec if you do have presbyopia correcting IOL.

I know of Dr Jim Gills. He does more cataract surgery than anybody in the US, maybe the world. I do not believe he does ReSTOR or ReZoom. He has given many lectures over the years at the major,regional,and local eye meetings on his Array experience. I know he tried Array when it first came out back in late 1997. He did not have a good experience, he stated. I know the protocol changed over time but he did not use the lens after that. I have heard that he likes to use a lens that is problem-free or gives the least amount of problems. I would love to know what he recommends for you. I believe his son, Pit ( I think is his name) Gills, uses different IOLs.

Good Luck!!!
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Avatar_n_tn
Thanks again, everyone. Actually, Eagle Eyes, it's Pit that's doing the surgery ("Jr.".) I'd also like to know the recommendation for an IOL before it's installed. I'll let you know when I find out.-Ken
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Avatar_n_tn
Thank you for mentioning your Dr's name and city. For those of us who are still looking for a surgeon that has an impeccable record it is tremendously important to know the names of actual surgeons! I don't know how many people travel out of their home states for cataract surgery-probably not many- but I would try and do that in order to get the very best outcome. Not very doable or even possible for most people but when you are scared stiff about the whole eye surgery thing you become a little crazy! I will be checking the outcome of your surgery if you post again-all the best of luck!
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Avatar_n_tn
I am a severe myope having cataract surgery at Johns Hopkins in a month and have decided to go with the   monofocal wavefront lens from Alcon.  I told the doctor I would like to be corrected to -0.5 instead of the -1.0 they usually do, as i would like to not have to wear glasses for distance vision.  My question is, what if any difference will this make in my intermediate and near vision?  Also, I have some corneal astigmatism in my one eye and I asked him about doing limbic releasing incisions to correct this at the time of the intraocular lens implant.  He replied that he rarely does that, although he did not give me a reason.  Is there another procedure that can be done to correct for astigmatism?
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