I am very nearsigted and have retinal detachments in both eyes, my left 17 yrs ago that was treated with partial scleral buckle and my right eye 5 months ago treated with vitrectomy; neither involved the macula. I am having caterat surgery in my right eye in 4 weeks with a mono vision implant as the nuclear cateract that developed is really effecting my vision. I was also told I have a Posterior Subcapsular Cateract in my left eye in which I see 20/15 distance but suffer from significant gare, particularly at night. What exactly is a PSC and can it be treated with a implant as well. How is the implant held in place? Would I be smart to put up with the extreme glare given my overall good vision in that eye and wait until the PSC gets worse to deal with it in the near future? How does the Dr. decide when to deal with a PSC? huberd
A PSC posterior subcapsular cataract is an opacification under the back surface of the lens capsule (go to Google IMAGE and type in the term to see a picture of it). It grows faster than "old age (nuclear and cortical) cataracts. It often is due to oral steroid use. Surgery is done exactly the same and it creates no problem. The most common type of IOL is held in position by being put in the capsular bag or ciliary sulcus and by the haptics (struts attached to the optic).
Cataract surgery will dramatically increase the risk of RD in your myopic eyes and with a RD in the other. You likely will have big problems in getting a highly myopic eye to work with your IOL eye as the IOL will get rid of the high myopica.
I'm -13 Diopters both eyes; I looked at the google picture - that makes sense. I was told I would have a higher risk of RD but not substantially given my high myopia and prior RD. I don't understand this part "You likely will have big problems in getting a highly myopic eye to work with your IOL eye as the IOL will get rid of the high myopica." Are you saying the two eyes will not work that well together ...one with a IOL and the other a GP contact lens? If so, would it make sense to have the PSC eye corrected via IOL as soon after the Nuclear cataract is corrected ...the glare in that eye is very bothersome? My RD surgeon did tell me the PSC has gotten larger. huberd
The surgeons will put in an IOL to leave you somewhere between "Plano" (no need for glasses at distance) and -2.75 depending on your discussion about where you would like your vision to be clear without glasses. It is unlikely that you will be able to fuse the different size images between a -13.0 contact and an post surgery refraction of 0.00 to -2.75.
Why don't you just wait till after the surgery to make up your mind. A few very special people can fuse images that are markedly different in clarity and size.
If you are a middle age male the risk of retinal detachment even without any complications is about 4-7% after cataract surgery and perhaps 1 in 2,000 before surgery.
I am 48 years old by the way. Thank you so much for your time and expertise; it has given me more insight into my issues. I plan on going through with the IOL surgery as I just can't adjust to one excellent sighted eye and one poorly sighted eye (20/70?) ...headaches, eye strain, and problems working/driving. I do plan to discuss my particular surgery risks with my retinal surgeon as well as with the corneal specialist who will be doing my cataract surgery. My retinal specialist seemed to be telling me months ago that cataract surgery would be a risk but a small one given the type of my RDs (traction) and their locations. The Corneal specialist said he wanted to "cheat" toward nearsightedness with my lens implant - maybe 20/40 after surgery given my degree of nearsightedness. I guess if I can fuse the images after my surgery, the decision may be made for me as to the other eye. I'm going in for another measurement test this week after 3 weeks w/o wearing my GP contact in that eye to get a good reading for the implant. Anything YOU would do different or other questions I should ask? - huberd
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