astigmatism

[margareta]

I am a dentist and was told I need cataract surgery on both eyes.  The ophthamologist said my cataracts are dense and would be more difficult.  I also have astigmatism and Adie's (?) eye.  I cannot afford to make the wrong decision because my career would be finished.  He is suggesting I have surgery immediately and has suggested the multifocal lenses.  However, after reading of the potential problems I don't think they are right for me.  Would you suggest Crystalens of different focal distance or both near vision?


This discussion is related to rezoom, restore or mono lens??? HELP.

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

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[JodieJ]

BTW, how much astigmatism do you have?  If it's more than than 2.25 D, you should probably go for Alcon's toric lens to reduce your astigmatism (instead of an aspheric lens, which won't do this.)  Be sure that your surgeon is experienced with implanting a toric lens.  Astigmatism can also be reduced at the time of surgery with limbal relaxing incisions.  A recent study suggests that the toric lens does a better job than LRIs in reducing astigmatism in an eye more than 2.25 D of astigmatism.  The toric lens does involve an out-of-pocket fee.  (Astigmatism will impair your uncorrected vision at all distances.)  

[JodieJ]

You can get more information about the aspheric Tecnis lens by watching the patient education video at www tecnisiol com.  (The Tecnis IOL is made by AMO.  Alcon and Bausch & Lomb also make aspherics lenses.)  Getting the type of correction described above by Dr. Hagan would probably give you better distance/intermediate vision than you'd get with the Crystalens, and you'd save thousands of dollars.  You'd need readers to see small print with either.

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

I am an eye surgeon and could not practice with poor vision. If I were having surgery I would have a high quality aspheric Tecnis IOL and plan on wearing progressive bifocals after surgery.  The "happiest" post op uncorrective refractive error is about -0.25 and -1.25 in the other.  If you already wear glasses and are use to them I see no advantage to the Crystalens or any other multifocal IOL.

You can always get a second opnion about whether you need cataract surgery. If your cataract is getting "hard" then its not a good idea to wait.

JCH MD