Wearing aphakic cataract glasses for 8 years....

[colley513]

And was wondering whether I can get rid of these things and look into an IOL. I am 33 yrs old, and my cataracts were caused by steroids that I had to take to combat pars planitis (a form of uveitus). I had two vitectomies (sp?) to clear out my eyes of the floaters and then two lensectomies to remove my cataracts, but an IOL was not implanted at the time. The reason given to me then was that if the infection resurfaced, then the IOL would be a hinderance to treatment. During the intervening eight years, I haven't had any recurrance of the uveitis, no red eyes, nothing. And I have adjusted fairly well to the cataract glasses, I can drive, I can tune out the "halos" that I see around lights and can even drive at night, but the lack of periphial vision  and the way these things look are major negatives. Is there  any problem adjusting to an IOL after wearing aphakic glasses for so long? Can anyone give me any advice in general? Thanks-

[John C Hagan III, MD, FACS, FAAO]

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[aphakicdad]

What type of contacts were dispensed to you?  Soft or RGP?  RGPs are easy to insert, have superior optics and are easy to take care of.  Kids wear them to camp, play basketball, soccer, go swimming and surf with them on.

[John C Hagan III, MD, FACS, FAAO]

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[SteelyNorm]

I am in a similar position except that I have been in cataract glasses for 30 years, and with an Rx of ~20D which is very high even for aphakic glasses. Unfortunately IOLs are not an option (something about lack of structures to anchor them) but have gradually gotten used to contacts with bifocals for reading and some uncorrected astigmatism in addition. Although I know CLs are sometimes frustrating, they have literally saved my vision in that with glasses alone I have such limited peripheral vision that even walking in a busy store is a thrill sport. And forget about anything close to normal reading through the bifocal segment, as the field is barely big enough to get one or two words into.

[John C Hagan III, MD, FACS, FAAO]

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[JodieJ]

I may be offering info that you already have.  Many stores (e.g., Target, Bed Bath & Beyond, etc.) have recently begun selling inexpensive magnifying mirrors (with magnification of 12x and more), which should help you a lot with the process of inserting and removing contacts.  It might also help if you wore your cataract glasses until just before inserting a contact.  You could also try a brand of contacts that does not need to be removed and re-inserted daily.  Alternatively, a one-day disposable contact might greatly increase your wearing comfort.

[John C Hagan III, MD, FACS, FAAO]

Well good luck, you seem to be assessing the risk/benefit ration closely as well you should.

JCH MD

[colley513]

I have tried the contacts with the progressive lenses over them, that was the original solution before I resorted to these cataract glasses. Should have included that in my original message. Unfortunately the contacts were the problem, they irritated my eyes, and having to put them in and take them out was also a huge issue, and I lost quite a few.

I did return to see the uveitis\retina specialist who did my surgery originally, and he said now my problem is basically "refractive" and referred me to a Dr. who does IOLs and all the other solutions for aphakia, but deferred to the refractive Dr's opinion about the solution to my problem. The pars planitis\retina specialist name is Dr. Mitchell Opremcak, in Columbus Ohio. (don't know if that means anything to you).

It do feel strongly about it but I definitely am assesing risk vs. reward at this point before I make any decisions.

[John C Hagan III, MD, FACS, FAAO]

I would suggest a trial of contact lens with progressive bifocals over them as much safer and less expensive.

If you feel strongly about it I would get at least three opinions: one from a cataract/IOL surgeon, one from a retina specialist and if possible one from a uveitis specialist.

The risks are significant and you could reactivate the uveitis and/or you could get cystoid macular edema.

JCH MD