IOL lenses strong prescription

[colinuk]

I'm 40 years old and have worn thick glasses all my life (+8.00 far sighted and astigmatism of -3.50) in both eyes.
Will IOL lenses be a possibility for me?

I have read about the tecnis symfony lens which sounds promising.

I am currently working abroad but will be returning to England in a few months time, freedom from chunky lenses would be amazing for me and would appreciate some prior information.

[JohnHaganMD]

Thanks for the follow up; best of luck

JCHMD

[colinuk]

Edit 31st july is my left eye. Right eye is still good

[colinuk]

Update

I have had the Zeiss trifocal lenses fitted because they are more stable for my prescription apparantly

pre prescription L     sph +7.75 cyl -3.50
                          R    sph + 7.00 cyl -3.50

24th july had right eye done (very happy) up to UK driving standard vision but still need reading glasses. They wouldnt tell me my prescription because it is fluctuating too much but around + 1.00 and cyl 0.5

31st July vision is not as good and is fluctiating wildly +1.00 cyl 1.25  I may have to have lag in 6 months time but sometimes my vision does
come into focus so am hopeful over the next few weeks

[colinuk]

Thanks for your response, some interesting points that I was previously unaware of.

Unfortunately for me Lasik is not an option as my cornea needs building up and not shaving off (don't know the technical terms). Also at the same appointment several years ago before multifocal lenses I was told that I don't have enough room for an accommodating lens.

However with advances in recent years I am now a bit more hopeful particularly now that multifocal lenses may be an option and accept that I may still need to wear glasses for reading.

[SoftwareDeveloper]

I don't know if LASIK or other surgeries might be an option, I don't know if they treat that level of hyperopia, but that might be a better option at your age, or perhaps a secondary  lens implant rather than replacing your natural lenses. A secondary lens can be more easily taken out or replaced if there are issues.

Unless your eye doctor sees some other eye health concerns, IOLs are likley a possibility, though I'm unsure if toric lenses by themselves correct that level of astigmatism usually or if some surgical correction might be needed as well. The largest correction for a Symfony toric lens seems to be:

http://www.tecnisiol.com/eu/tecnis-symfony-iol.htm

2.57 D at the corneal plane, I hadn't hunted for a calculator to see what that works out to at the spectacle plane to compare. Astigmatism mostly comes from the cornea, but it is possible for some of it to be lenticular (in which case that goes way when the lens is removed), I don't know how large that might be in your case, though I don't think its common to have much. Eye doctors do scans that determine the corneal astigmatism. At least in the US there are surgeons that will do a free consultation with those considering surgery, which includes the various eye scans needed to evaluate your lens options.

However  at 40 you still have a lot of accommodation left,  and no lens yet is a perfect replacement for that, there is a chance you'll need reading glasses. Even if most people with multifocals or the Symfony get away without reading glasses, some do still need them. The odds are in your favor, but obviously some folks will have bad luck.  

Cataract surgery  is the most common surgery and overall low risk, but as with any surgery there are still risks so you need to decide if the benefit is worth it (which is mostly equivalent of course to a lens replacement, its only some rare cataracts that may have some higher risk of tearing the capsule when they are removed). I had to have cataract surgery, in my case I personally wouldn't have considered it worth the risk to have voluntary lens replacement, but others may.   I have a thread about the Symfony where I note my good experience with the lens itself, but I have a rare side effect of having had surgery that is problematic still 2 months after surgery, due to my iris (and perhaps lens) jiggling. The issue will likely resolve itself, the point  is merely that even with a mostly safe surgery, there are risks.

There  seem to be more risks with highly myopic eyes than farsighted ones (though admittedly I hadn't paid attention to the issue of highly hyperopic ones so I may not have noticed their issues). The  issue I've had is something its unlikely you'd ever encounter, its  rare and more likely with someone highly myopic as I was, the point is merely emphasizing that there are risks, even if the odds are things would go well. Highly myopic eyes have internal structures that are usually larger than normal and the artificial lens is hence smaller in comparison the capsular bag the lens is in, so it shrinks and the iris looses support (though usually even then there isn't a visual artifact, my case isn't common, and it may be partly the lens moving rather than merely the iris). A hyperopic eye is likely to be smaller than usual so there is likely even less risk than usual of that sort of side effect.