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Avatar universal

cataract surgery for extreme myopic

My correction is in the area of 16 diopters. I have developed cataracts as a result of treatment with Prednesone for what was thought to be Temperal Artiritis. That diagnoses turned out to be wrong but I was left with cataracts.

What are the risks for me in cataract surgery? What type of lens would be best for me?
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1573381 tn?1296147559
MEDICAL PROFESSIONAL
Slightly increased risk of retinal detachment after cataract surgery but not really in the hands of a very experienced surgeon.  As far as the lens, you may want to be conservative and go for monofocal regular IOLs to clear your distance vision and wear reading glasses afterwards.  Given you are at increased risk of other problems not related to the cataract surgery (CNV, myopic degeneration, glaucoma, etc), it would be best to have a regular lens rather than a specialty lens.  This is an individual decision though and you need to fully discuss it with your surgeon.

hv
Helpful - 1
Avatar universal
Many (but certainly not all) retinal surgeons recommend acrylic rather than silicone IOLs for their paitents.  If retinal surgery with silicone oil is needed in the future and a silicone IOL has been implanted, the oil can adhere to the IOL and block the surgeon's view of the retina.  My own retinal surgeon suggested that I get any IOL I wanted, as long as it was acrylic.

Dr. Oyakawa, who responds to questions on the community eye care forum, has reported good results with the Cryslalens in his own eye, following retinal detachment repair and epiretinal membrane removal.  (I don't think that Dr. O was a high myope.)

As a former -7 myope (now plano with IOLs), I do miss my sharp near vision when it comes to performing certain tasks (like inserting a contact lens.)  But you're right, Dr. Visoghi, I don't know what -16 myopia is like.  Maybe I'm prejudiced by my very positive feelings about any version of monovision.

Helpful - 0
Avatar universal
I am -16 also, and was looking at Crystalens. Would love to have the advertised benefits. After discussions with 2 surgeons, and lots of research online, I have found that there are many potential problems with this product and other "Premium" lenses, for a -16. ( A -8 might be a fine candidate, however)
1. Only the older Crystalens 50 can correct a -16 eye, this lens offers little accommodation, around -0.5. You still need reading glasses. (The other "premium" IOL's can't correct a -16)
2. This lens comes in 1 diopter steps, so getting the power correct requires great skill on the surgeons part, and just plain luck. You will most likely need laser correction to get distance vision corrected.
3. Being -16, you are at risk for retina problems, I have had multiple retina surgeries including a Scleral Buckle and a vitrectomy. The vitrectomy replaces the Vitreous fluid with SIlicon oil, some feel that a silicon lens is incompatible with silicon oil. I have seen posts indicating that it is safe, as well as other's that say it will cloud the lens, and should be avoided. I feel that acrylic lenses are the safer choice.
So I have concluded that "Premium" lenses do not work for a -16. And I am planning to get Acrylic lenses set for monovision, when I have my surgery in a few weeks.
@ seawife2: There is a huge difference in a -8 and a -16. I am not a Dr., but I believe the "premium" lenses would work very nicely for you, assuming you don't have other risks, like retina problems, glaucoma, diabetes. I really like the Crystalens, in theory, and B&L advertises a very high success rate. They are considerably more expensive, but I would find a way to pay, if they would actually work for me.
Helpful - 0
1573381 tn?1296147559
MEDICAL PROFESSIONAL
For a minus 16 patient, they don't have good near vision either without glasses so will not be too difficult to adjust to distance lenses plus reading glasses.  You are on the money though on 99% of the info in your posts!  Appreciate your help.

HV
Helpful - 0
Avatar universal
Why do you suggest acrylic rather than silicone? I am very myopic, -8, and will be having surgery soon.
Helpful - 0
Avatar universal
If you've never tried monovision with contacts, you might still be an excellent candidate for mini-monovision.  Some formerly nearsighted people have a problem adjusting to the loss of near vision if both eyes are set for best distance vision.  You will want to get acrylic rather than silicone IOLs in a brand/model that comes in the power that you need.
Helpful - 0

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