Can lens implants be replaced?

[bander]

I had cataract surgery on both eyes in my early thirties. Up until I reached about 50, I only needed glasses for close-up and that wasn't 100% of the time.  By the time I reached 50, I needed corrective lenses for both close up and distance.  I was told that I couldn't see well enough to pass a driving test.  I know that a lot of improvements have been made as far as the type of lens implants that are used and the procedure itself.  When I had cataract surgery, it involved shots around the eye and actual sutures on the eyeball.  Has anyone ever heard of having lens implants replaced?  I know that a lot of people may not be concerned with this -- especially if they are older when they first have cataracts; but I'm still relatively young (56).  I currently wear contact lenses, one to correct near vision and one to correct distance vision.  I tried both progressive lens bifocals and the ones with a line in the middle.  I could only tolerate wearing either pair of glasses for distance.  I know that I will probably one day reach the point that I might have difficulty putting in and taking out contact lens.  It would be great to be able to have the current implants replaced by better ones if it is possible and it would improve my vision.

[petul22]

I am 67 years old Now had 20/ 20 vision  with laser eyes surgery 9 years ago. May 2017 I had Cataract Surgery in my Right  and back to wearing glasses, I have lost my confidence in driving and not happy  as my sight seam to be worse can it be corrected....

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

If you have 20/20 with glasses then make your peace with glasses.    

[Hussein_1234]

You should try first Yag Laser Operations , it takes nearly 5 minutes and you go home with normal vision after hours to days , because it removes the cloudiness on old lens

[JohnHaganMD]

Clarification when "secondary cataract" develops and yag laser capsulotomy done its not the IOL that turns cloudy but the part of the person's original natural lens (called the posterior capsule) that turns cloudy. It is left in the eye to hold the IOL in position.

[JohnHaganMD]

Thanks for your help  CBCT I thought the question was about the old IOL not the old natural lens

JCH MD

[CBCT]

In answer to your question -- no, your "old" natural lens cannot be reattached.  It was broken up and vacuumed out when you had cataract surgery.  Take Dr. Hagan's advice and see your opthamologist.  Best wishes.

[JohnHaganMD]

It is more likely that your problem is not due to the IOL in your eyes but some new problem in a different part of the eye (example glaucoma or age related macular degeneration) or the membrane behind the IOL could be cloudy which is an easy fix with a yag laser capsulotomy.  You need to see an eye MD ophthalmologist to determine of the many possible causes why your vision is not good as well as check your fellow eye
JCH MD

[k2010022]

Can surgeons reattach old lenses? I had cataract surgery and now my vision is more blurry than it was without the cataract surgery.

[SoftwareDeveloper]

Most of the problems on this page regarding IOLs are presumably due to residual refractive error like astigmatism, myopia or hyperopia (unless they were due to vision being degraded by the IOL being clouded by PCO, which is treatable with a laser).

If there is a refractive error that is causing your visual issues  then it should be treatable with contact lenses or glasses. Even if you might decide another aproach is more convenient, those should at least work.   If you can't fix the error with contacts or glasses, then it is likely something that can't be treated by exchanging the IOL since the IOL is merely another lens implant.  You ask if the doctor would refuse because "glasses are a viable alternative", but it sounds like you are saying glasses don't fully solve the problem so they aren't a "viable alternative". It sounds like you need to ask the doctor  to experiment with other glasses or have them search  another problem if glasses aren't fixing what they thought the issue was. If you can't correct it with glasses or contacts, it seems unlikely that an IOL exchange could help.

If the IOL itself were causing a problem (other than merely not being the right lens power, which glasses/contacts would solve) and glasses/contacts couldn't solve it,   that would be a different story and a lens exchange would be something to explore. However the sorts of issues IOLs sometimes cause  are   things like halo or    flickering lights, and I don't think its likely an IOL glitch would be the reason for   the sort of issue you are describing (though I can't say for sure, I'm not a  doctor but have merely read a lot about IOLs due to having issues myself).

If people do have problems with an IOL being the wrong power, then most doctors prefer to correct it via either wearing glasses/contacts, or with some sort of laser correction to the eye rather than what seems to be the larger risk of surgery. If they do use surgery, often they may prefer things like an ICL (implantable collamer lens/implantable contact lens) or a piggy back IOL. However in most cases, worst case a lens exchange is possible if its truly needed, they merely discourage it due to the risk of surgery. If you have had a YAG treatment to treat PCO a lens exchange often becomes more problematic but is still usually possible.
.

[CBCT]

Is this double vision new?  Does it only occur at distance?  Have you been examined by an opthamologist lately?  

[rpjkw11]

I had cataract surgery in 2003. My problem is they are slightly "out of phase", that is I see two of many things, such as watching birds. I was given a pair of glasses to correct that, but they didn't seem to work well for me. The "double vision" seems to be getting worse, though I can live with it rather than resorting to glasses. Can my lens implants be replaced? Would doctor refuse because glasses are a viable alternative?

[Mauri79]

I had cataract surgery with intraocular lens put in.  It took me a long time to come to a conclusion that my left intraocular has incorrect prescription and changes in my glasses prescription were of no help.  I am having double vision , viewing images slightly larger than what my right eye (the perfect one) is viewing.  This issue has me feeling a bit of disorientation all these years.  What can be done to correct this situation.  I had insurance then, but no longer.

[Craig10x]

You're welcome, Joe...glad to be of help...yes...exactly....once both eyes are corrected (the other eye to 20/20) then it will be much easier to tell what will work best for you....then, you can always do a contact lens trial to see how going to mini-monovision or to full 20/20 correction would be like for you and make it easier to make a decision on which way works best overall for you...

[joe49424]

Good morning Craig .... thank you so much for your input .... I agree with your thinking, Lasik would probably be a much better choice than lens replacement. I'm thinking I could also use a contact lens to simulate how 20/20 distance vision would affect my near vision and if I'd be happy with it. I'll discuss this with my doctor when I see him next week. Thanks again.  Joe

[Craig10x]

Well, if it doesn't work out well for you (after having the other eye done to 20/20) then you could always consider a lasik touch up to bring you up to 20/20 in the first eye you already did...what is your left eye set to in diopters (example: -2.25 diopters) That is what i had originally (20/20 in dominant eye and non dominant was set to that amount)...

I wasn't totally happy with it and they did a lasik touchup which brought me up to -1.0 diopters which is what is known as mini monovision....I like it much better though sometimes i do wonder if i would have been happiest with 20/20 on both eyes (even though readers would be needed more often)...

You could have that lens exchanged but i think most surgeons (including mine) usually feel that if a lens is set in well, that they would prefer to get the less invasive route and do a lasik touchup instead of explanting and replacing a lens...

So, you might want to wait until the other is done for 20/20 and then give it time to see if you like the way you are now...and if not, then consider either mini monovision or going for full 20/20...

[joe49424]

Just within the last week I had a monofocal lenses implanted and set for near vision as opposed to far vision. The operation went smooth and the results so far are good.
But I've been haunted with the feeling that I should have went for far vision which is what I understand most people do. My second eye is scheduled to be done in 11 days. I am on here because I don't know how difficult (or dangerous) it is to replace a recently implanted lens.
After reading many of the posts on here I'm thinking I should just be happy with my near vision results and not try to switch to distance. It sounds like I could open myself up for more problems if I do.
Any thoughts, comments or personal experiences would be appreciated.
Thanks in advance.

[wrongimplant]

PS - I forgot to mention that one doctor suggested an implant over implant and more recently one doctor said I was a candidate - at a later date - for Lasik treatment for a developing  "second cataract" (common name).

[wrongimplant]

About three years ago I had perfect near vision - could read perfectly without glasses any tiny print; only needed glasses for driving - to better read signs from the distance - but I could drive without them.
Due to the danger presented by cataracts when driving at night, I agreed to the operations.  Since I do not drive often but use my near vision a lot - computer, writing, painting, etc. - I made that clear, that I wanted to preserve my near vision without the need for glasses; whereas I did not mind using glasses for driving.
As it turned out, the doctor admitted to using the wrong Medicare-provided implant and now I need glasses to peel a potato, to read the stove knobs, for reading small or large print, to work on the computer, for driving and everything else. He also missed a problem that had developed in the macula, taken care by the second eye doctor. During the operation, I heard him complain about how hard the cataract was. After the operation and because of the vision problems that ensued, I searched the net for "hard cataracts" and how not using the new methods to deal with them could cause eye problems.
With the implant on the other eye, I almost do not need glasses for driving (not my priority now or then). I do not know if that second doctor could have made some adjustments to give me back some better near vision but he did not. Both operations were performed at major centers (under Medicare and my supplemental insurance).
People I know - ages 70-97 who had the operations years ago having had the standard Medicare implants, can read well without eyeglasses.  Some people having recent operations fared that well too.

In my case, is there the remote possibility of changing implants or - as one doctor suggested - placing an implant on top of the other?  I also wonder if - with my quasi overall good vision - I should have any implants after all. I would not mind using glasses for small print, but needing glasses even to read fonts 12, 14 18 24 (I cannot see font 12 at all and from 14 on it gets really blurred).  The macula problem was resolved with medication but my vision with and without glasses is uncomfortable to say the least.

[Chatelaine03]

Read your comments with interest.  In Feb 2011 I had a multi-focal iol put in my left eye to correct a cataract.  So - short story - wrong lense put in - now no distance vision without glasse, and I cannot estimate side to side vision .  It turns turns out I never had a cataract in the first place!
Since then referred to a proffessor in Toulouse, France - checks over the past year - and promised to replace the lense.  Today,I had a phone call saying that there will be no operation - and no further appointments!
I can see reasonably well with my glasses, but I still find it takes a good hour before my distance vision  sufficiently adjusts so I can drive the car, and   side to side distance vision is still dodgy!
What do I do now?

[swagat_j]

Dear Sir,
I replaced my older lens because of not good vision, i had injury in my left eye in 2002. so my cornea was damage ,that time  i have cataract also due to injury.  now this days i change my older lens to new lens every thing is fine but after surgery i had a  pigment on the lens implant there is any way to cure this i have only 5% Vinson due to this  pigment dr. said that this pigment now cure only way of my body Response and eye water clean it self only. other then u has no Vision so any suggestion from your side i m 29 year old and i m worried about this very much
sorry sir for my bad english.

[OldNavy966]

Newer is not always better.  If you search hard enough you will surely find an opthamologist to replace your IOL.  That doesn't mean you should.  I've never come across a person on this board who has replaced a monofocal IOL for a multifoca/accomadative IOL but this board is littered with people who have or are seeking the oposite.  Such as myself.  

[berrywoo]

Your vision problems are probably more associated with the general changes that occur as people age not with the IOL.
Explantation can be done, but most people who have explants are those with a multifocal who are dissatisfied with the dysphotopsias and other aberrations that have happened as a result of the implantation of a premium IOL.
Generally, the satisfaction rate for a monofocal IOL is greater than for a multifocal IOL as Dr. Hagan's research shows.
Piggybacking is generally done when after the first IOL implant there is an unexpected refractive error and the patient may benefit from an additional lens. However, there are risks and certain qualifications that must be met before another IOL can be implanted.
Take Dr. Hagan's advice and have your eyes thoroughly examined by an ophthalmologist.

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

Bottom line is that if the IOL is not causing the problem a newer IOL won't help. You need to see an Eye MD ophthalmologist for an evaluation.

JCH MD

[bander]

I just read your response to my question again and I noticed something that I didn't pick up on the first time I read it.  You mentioned that the difference between a 1980 IOL and a 2009 IOL is not that great for people with normal eyesight.  Before my cataract surgery, I didn't have "normal vision."  I don't know what my vision was, but my glasses had lenses that were pretty thick. If my vision was pretty bad, would the difference in the IOL's make a difference?  Thanks for your imput.

[bander]

After I sent my question about having implants replaced, I saw some questions where people were talking about explantation and piggy backing lenses.  What is explantation and when it that appropriate?   In piggy backing lenses, when would that be done?  When I read these, I was thinking that one of those might be an option for me at some time in the future.  My vision is not as good as it was when I first had cataract surgery; so I'm hoping there is some safe option out there that may provide better vision.

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

Surgeons do not take out "old" IOLs and put new ones in if the old ones are providing good vision even if that means wearing glasses or contacts. The risk is too high and the difference between a 1980 IOL and a 2009 IOL is not that great for people with normal eyesight

JCH MD