Crystalens replacement if lag laser was done

[ML4604]

Can a crystalens be replaced with a different power if the patient had yag laser done while having the present crystalen in the eye?

[Michael J Kutryb, MD]

The answer is yes - but it is more difficult.  Generally it might be a better idea to  place a monofocal aspheric lens as the replacement lens if you were going to have the original crystalens explanted.  Generally if crystalens is used and power is significantly off, the first choices to improve vision would be lasik or piggyback IOL - not IOL exchange.  That is usually reserved for someone who is having unbearable visual side effects from the lens or someone with a lens power that is way off and who has not had a yag laser.
Michael Kutryb, MD

[ML4604]

Re:  Crystalens replacement after yag laser

My doctor was going to place a lens, I believe an Implantable contact lens in front of the crystalens but I have formed Elschnig Pearls and they did not stay just at the edge, they are creeping past the edge.  He said to remove the pearls is no big deal, but his question is if the additional implant is put in place and the pearls decide to grow again, will they creep in-between the lens and then what?  My surgery was cancelled till he gets another opinion from someone who deals with crystalens and Elschnig Pearls after lag laser.  If you have any addtional information please advise.... Thanks!

[Michael J Kutryb, MD]

Yes, this is a tough case.  I wonder why the original IOL cannot be left in place and LASIK done to reduce refractive error.  I suspect the crystalens may be shifted out of place, or tilted abnormally?  It sounds like it might be difficult to get this current IOL out of the bag,  A vitrectomy may need to done and a new monofocal aspheric IOL placed in the ciliary sulcus.

Michael Kutryb, MD