Cataract Vision

[ke4yyd]

I recently had cataract surgery and because of problems a different doctor was involved with the left and right eye.  The right eye was done first in May 2007.  The IOL was a AMO Tecnis Z9002.  In October 2007 the left eye was done using an AMO ClariFlex IOL.  Corrected vision is now 20/20 in both eyes.  However there is a noticeable difference betwee the "quality" of vision.  The right eye appears much "brighter" with more contrast.  Like the difference beween a $1500 pair of bincoulars and a $100 pair. The left eye, as compared to the right, appears to have a light gray tinted filter.  Is this vision differences I have noticed the result of the different IOL characteristics or could this be the physical differences in the eyes.  Research on the internet does indicate different characteristics between the IOL's.  

Why aren't the different IOL characteristics discussed with the patient particularly if the IOL's used are of a different type

[John C Hagan III, MD, FACS]

All IOLs presently used are the same type (posterior chamber IOLs). There is very little difference between the two IOLs you mention (technis z9002) and AMO Clariflex IOL. They are both made by the same company. There is no IOL that has shown itself to be so superior to the rest of the field that it is the conscensus "best" IOL.

Moreover every facilility could not afford to keep every type of IOL in stock like a smorgasborg and let the patient chose. Every surgeon will not be able to achieve expertise with each IOL if they let the patient pick the one they wanted. Surgeons will chose which works best for them and has good cost and availability parameters.

Even in studies with patients having the identical IOL in each eye one sees better, has better night vision, the surgery went easier, one sees better without glasses, etc. Pair organs ears, eyes, kidneys are not exact duplicates of one another. In all likelihood the difference in vision is doe to the other parts of the eye that were not operated on rather than the IOL in the eye.

JCH IIII MD