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Lasik after cataract surgery versus lens exchange to o correct to plano...
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Lasik after cataract surgery versus lens exchange to o correct to plano

I had a toric lens implant in my left eye 4 weeks ago. I had requested good long distance vision but have ended up with good computer distance vision. At 3-week post-op consult with MD he stated his target was 2 meters (or approximately  6.56 feet). The vision is stable in the left eye at 1 and 3 weeks post-op. There is no need in the foreseeable future that cataract surgery on right eye (dominant) will be necessary.
MD recommends Lasik surgery to give distance vision in left eye as I had hoped. I was uncertain that I wanted mono-vision (ultimately) when the surgeon suggested it to me originally and  thought I might eventually prefer good distance vision in both eyes whenever it became necessary for the right eye cataract surgery.

Questions : 1) if the left eye is corrected to plano (good distance vision) with Lasik surgery will the focal difference between my eyes be difficult to get used to, if sometimes I choose not to wear eyeglasses?
2) Will presence of Toric lens affect the outcome of Lasik surgery or vice-versa
3) do the risks of Lasik surgery outweigh the benefit of (hopefully) achieving good long distance vision ? (probably only I can answer this).
4) is lens exchange worth considering -- or too risky ?

My near vision unaided (per referring optometrist's notes) presurgery was 20/25-1 in the right eye and 20/80-1 in the left eye.  The far vision unaided was 20/60-1 in the right eye and 20/200 in the left eye.
My presurgery readings/ ? correction varied between the initial exam with the (referring) optometrist and the second exam by the optometrist connected with eye surgeon's office .
referring optometrist:                   left eye : - 3.50, -1.50 x 095        right eye: -2.00, -1.00 x 085
optometrist @ surgeon's office:    left eye : - 5.50, +1.50 x 3          right eye: -2.75, + 0.75 x 11
My readings/or recommended correction at 3 weeks post-op :    OD - 2.75  +1.00  x 10;  OS -1.25  DS  

                                          


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Dear rsdixon,

I would recommend that you speak further with your eyeMD about your options.  Before any other surgical intervention is performed, I would recommend that you try a contact lens for a few days to make sure that you will adapt to the loss of intermediate vision.   If you do, you could undergo a lens exchange or LASIK and both options will work for you.  Since the IOL exchange is an intraocular procedure, the risks might be slightly higher than LASIK. Speak with your eyeMD further.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California
2 Comments
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thank you for your response.  When I asked my eyeMD about trying out a contact lens -- originally, I was thinking of doing it for the right eye (non-surgical eye) and seeing how I liked the "monovision".     He did not seem interested in trying me with a contact at the last visit we had saying "that brings in other problems" or something to that effect.  I think he is hoping I will accept Lasik (which he does) and does seem less invasive to me.  However, the idea of trying out a contact on the surgical eye -- to see how it feels to have one eye with good long distance vision and one eye with passable reading vision (right eye) sounds like a smart idea before going ahead with anything permanent.  What I had hoped for was long distance vision in the surgical eye -- I am curious if it might be a challenge to adapt to -- having my surgical eye at "plano" and my right eye where it's at -- good enough for near reading but not for intermediate vision.  When I view things without my glasses now -- since both eyes are somewhat close -- it seems I naturally use the eye that gives me most clarity -- although the eyes are not that far apart right now.  anyway -- it's all quite interesting.  Wish my MD had communicated with me more thoroughly.
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