You're welcome
JCH III MD
Thank you both very much for your responses. Dr. Hagan, I really appreciate your help.
And also you JodieJ
Thank you again
The IOL Master output can provide power predictions for different IOLs given the patient's eye measurements and the surgeon's results (if available) with a particular IOL. I suspect that the Alcon reps programmed your surgeon's IOL Master to provide output for most of Alcon's lenses, including models rarely used today. Yes, opinions vary, but I do think that an aspheric monofocal lens is currently considered state-of-the-art. It's reported to provider sharper distance vision, less glare, and improved contrast sensitivity/night vision relative to a spherical (conventional) IOL. AMO, Alcon, and Bausch & Lomb all make aspherical IOLs.
Yes, your axial length shows that you do have long eyes. But an IOL is implanted near the front of the eye, and its size relates to width (rather than length) of the eye. So one size can fit all.
The way I see it, just about everyone is high risk for something bad. I don't want to minimize your risk, but it appears that you have about a 92 to 95 percent chance of NOT experiencing RD (which can usually be surgically repaired).
1. Just as there is no "best automobile" and many brands of cars are used throughoout the world so too it is with IOLs. There is no best IOL and many work just fine. If I were having surgery on me I would want a tecnis aspheric IOL, Alcon makes find implants. I would avoid multifocal IOLs especially the problem prone ReZoom.
2. "injectable" just means it's soft and can be folded like a taco, put in a "shooter" and put into the eye through an incision that will only need to be half the size as if it were not folded.
3. The IOL Master does not tell the surgeon which implant to use.
4. An oil drop cataract is not the same as a posterior subcapsular cataract.
5. Using different types of monofocal IOLs are not that much different and I would not be concerned if an good surgeon was using his first IOL if monofocal. I would not want to be any surgeons' first, second, third, ....... up to about 20 cases of multifocal IOL like crystalens or ReStor. Forget the ReZoom.
6. You absolutely will be at very high risk (5-8%) of RD after successfull IOL surgery and much higher if complication occur like capsular tear/vitreous loss. You absolutely don't want to have surgery until your vision is a BIG problem. Your demographics are the highest of any for RD after cataract surgery.
5. One diameter will fit all because the flexible parts (haptics) will expand or compress depending on the diameter of the capsular bag where its put. The POWER however is different for different people and the reason why all the tests are done before surgery.
6. You are not the typical case. you are high risk.
JCH III MD
In response to your final question, several months ago I read an article suggesting that the newer acrylic IOLs appear to degrade from exposure to presciption and nonprescription eye drops. When I raised this issue with my cataract surgeon, he just rolled his eyes and shook his head. Maybe the more relevant question is whether WE are going to be around in 30-40 years.