Implantable Lenses

[etrader]

Hi, I am 47 and 8 months ago had a cataract in my right eye removed - monofocal IOL inserted.

The right eye is now +0.5  with a bit of astigmatism.

I have a VERY slight cataract in the left eye, and I mean slight, it does not bother me at all and hopefully it will be years before it needs an IOL.

My surgeon recommends IOL surgery in the left eye as well - to give me some balance (I am -6.0 in this eye.)

I am reluctant to have IOL surgery in the left eye as the right eye is not perfect - I am getting a lot of glare from overhead lights which is annoying, my surgeon tells me there is a chance the left eye will have the same problem.

So to give me better eye balance I am thinking about an implantable collamer lens in the left eye. If the cataract needs doing in 10 years time I can have the implant removed at this point and perhaps it will cause less problems than an IOL - I will retain some reading vision for example.

Is this a sensible route to take, are there any pitfalls to consider.

[Jerry_NJ]

I have a cousin, male, who at age 65 or so had to have cataract surgery. He loved the results so much (no need for eye glasses or contact lens for that eye) he told his doctor to do the other eye.  The doctor advised against it (even a the advanced age) but my cousin insisted and the doctor did the same to the other eye.  My cousin said the second eye was as good.. vision not as good.

This suggests to me:
1) even successful outcomes may be different eye-to-eye.
2) there is a risk, my cousin didn't lose that battle

I would opt to put off surgery/risk as long as I could... just wear eye glasses or use contact lens.

[flossy93]

Are you wearing contacts or glasses to correct your -6D eye to match your operated eye?  If you have contact lenses availablem, do you still feel the vision 'imbalance' when wearing one to correct your -6D vision to the same acuity as your eye with the IOL?

Re your question, I was told by my optometrist in passing that cataract surgery down the road is more difficult in patients who have had an ICL implanted.

Although he is not an ophthalmologist, he is very well informed - and his wife has your exact situation and is searching for an experienced cataract surgeon now who can extract the ICL and treat her now-ripe cataract in the same eye.

She had the ICL implanted because she had an early cataract in the other eye which required treatment in her mid-40s.  She was a -12D and found the 'imbalance' between the eyes problematic.  

Although she was very happy with the ICL results, apparently it does make the ultimate cataract surgery in the same eye more challenging.  

There are some other potential side effects of having an ICL inserted (in addition to the risk Dr. Oyakawa mentioned of potential cataract formation/acceleration).  

If you do decide to go forward with an ICL, please do substantial research about the risks and benefits so you will be well informed.  It may be a good option for you..

By the way, what did your surgeon say is the reason for the glare you are experiencing with the monofocal implant?  I can understand your hesitation in having a similar procedure in the second eye if the first is still giving you unsatisfactory vision.  

You may benefit from a second opinion from a different doctor/practice to evaluate if there is any problem with your first implant (positioning etc) contributing to the glare issue.  If I were you I would want to understand what the reason is for the glare, before having another procedure.

[Ray T Oyakawa, MD]

A complication of an implantable cl is cataract. You will be better off with early cataract surgery.  This will be one surgery vs. two.  

Dr. O.