IOL in one eye

[zspi]

My 18 year old son was in an accident and developed a traumatic cataract due to the accident.  He is now needing to have the cataract removed.  At first we thought that the Restor would be the answer, but after a lot of research, we are afraid of the problems that people are encountering.  He is too young to be having problems with halos and night driving. He wears contact lenses in both eyes and his vision is -7.0. He likes to wear his glasses in the morning and at night to watch tv before bed.  Would there be a problem wearing glasses after he has  the lens implant in his right eye?  His Dr said he would need to wear contact lens in his left eye, regardless of what type of lens he had implanted in his right eye. What kind of problems has anyone encountered with an IOL in one eye only?

[Michael J Kutryb, MD]

It shouldn't be a problem as long as he can wear a contact in the other eye.  The issue here is his nearsightedness (myopia) with refraction of around -7.00.  Now the brain will generally well a difference of more than 2 diopters between the eyes.  So if the bad eye is corrected with an IOL to near plano (zero refractive error) then the other eye would be severely off balance.  Glasses will not work in this situation to correct the imbalance (look up anisometropia) BUT contact lenses will and the brain will not recognize the huge difference if a contact lens is worn.

There are two other options to think about.  First the bad eye could get an IOL leaving him at around -5 or -6 or -7 to basically match the other eye and of course require glasses for both eyes.  I probably wouldn't do that myself as long as contacts could be worn.  Second, the bad eye could be corrected near plano and the healthier eye (-7) could have LASIK to correct it's nearsightedness.  That is the most exciting option to me but I would want to make sure the first eye was recovering well and had good vision and was safe for the long run then and only then would I consider having surgery on the good eye.

By the way, I would avoid the multifocals in this case, just my personal preference for someone his age.

[londonbridge]

I have one IOL with a -7.0 prescription in the other eye . I had Restor with very bad results, you can read my archived posts and had it explanted. I chose a monofocal torric set for intermediate distance. With a contact in my non IOL eye set for distance I am able to see distance, intermediate and all but small print. I wear reading glasses.

The biggest problem is that my eyes are now 7 diopters apart which means that when I take my contact lens out I can no longer wear glasses, the eyes are too different once they are more than 3 diopters apart. I have adapted but cannot drive that way so he would likely be very dependent on the contact lens. The other choice would be to have the second eye done. I am functioning fine however and will wait to do my second eye as the cataract is quite minor. It is really just a matter of convenience.
Hope this helps.
londonbridge