Lens Replacement for Non-LASIK Candidate

[ladyryan]

I appreciate the opportunity to post on this forum and I apologize if I ask a repeat question.  I found out this week that I am not a candidate for LASIK due to my high prescription and thin corneas.  The doctor told me about one other option called Clear Lens Replacement which is similar to cataract surgery.  I understand that it would cost a significant amount of money and involve more risk.  I am 29 years old and my vision is so poor I cannot walk without my contacts/glasses.  I still have to make an appointment to learn the details of this procedure from another doctor, but if you happen to have any comments or suggestions, they would be greatly appreciated.  I am hoping other options may become available in the years to come... but do I want to wait that long to fix my handicap?

[keenanslenker]

Okay, so myopes aren't good candidates for the procedure due ot the risk of retinal detachment. However, I am a +9 with astigmatism in both eyes. Would this procedure be a sensible alternative for me?

[James J Salz, M.D.]

I agree with the other posts.  We are all assuming you are highly nearsighted and not highly farsighted.  Highy nearsighted eyes already have a significantly higher risk of retinal detachment and that risk is increased even more with clear lensectomy so it is not a good option.  The best surgical option is called a phakic lens implant and you  can research this by doing a google search on STAAR Visian or AMO Veisaye.  If you are highly farsighted, then the risk of a retinal detachment is much less and clear lensectomy can be considered.

[MamaZ]

Dr H is right.  You are way too young to risk this.  

Dr. H.  I can tell you rock!

[ladyryan]

JCH MD - Thank you very much for your expert opinion.  I was not seriously considering this option, and your words of wisdom will definitely prompt me to do some serious homework should I change my mind.  Again, it is my hope that alternative procedures are developed in the future years that include less risk.  I had to wear my glasses for four weeks prior to my LASIK consultation so I am thrilled to be back in my contact lenses.  I will forget about my vision problems until the next big thing.  For now, I am lucky to have the ability to correct my sight, while there are people out there who have none at all.

[John C Hagan]

This is my personal opinion as a board certified ophthalmologist that has performed over 11,000 cataract/intraocular implant operations. I do not recommend this procedure to my patients. With your high myopia you are an increased risk of having a retinal detachment. Cataract surgery (or clear lens extraction-basically the same operation except that in the latter there is no cataract and the lens is removed to put an implant in to get rid of thick glasses or contact lens). increase the risk of retinal detachment by close to a factor of 10. Not 10 % but 10 X. Your risk of retinal detachment after surgery (if its not complicated) could be as high as 1 in 50 to 1 in 100 depending on your degree of myopia, the length of your eye and structural weak spots on the retina. If the procedure is complicated by vitreous loss (the most common surgical complication) your risk could rise to 10%. The there are the standard risks of infection, bleeding, inability to insert and implant, problems with implant power, etc. You may still need glasses and/or contact lens after the surgery. The worse risk is complete loss of all vision. It happens, not often but it's quite different when it happens to someone that was severely handicapped by cataracts. It's yet another when its done to get rid of glasses or contact lens. And you will have to have the operation on both eyes so that doubles each risk.

There are some very skilled and ethical ophthalmic surgeons that do this procedure and believe in there merits of doing this on high myopes. I am not one of them. Be certain your clearly understand all the risks you are undertaking.

JCH MD