choices

I had an eval yesterday for Lasik correction. I do not have cataracts and currently wear  progressive glasses and vision is corrected to 20/20 both eyes. Rx hasn't changed in 2yrs for glasses.Trying alleviate the wearing of glasses due to inconvenience in FL lifestyle. Dr. suggested that implants ( CLEAR )  would be better alternative than Lasik due to aging process effects on lens and that it would be unsure how long Lasik would be effective. However after reading some of the horror stories on this site I am getting a little reticent about have invasive surgery plus a product that really has no long term history, to relieve what is now only an inconvenience (never mind the expense) Any sound advice from the resident experts?


This discussion is related to Crystalens vs. Restor Lens IOL implants.

[des900]

Since you do not have cataracts, i suggest you to continue using progressive glasses as its more convenient plus it gives some protection to eyes.

[Ray T Oyakawa, MD]

Really depends on your age and if you have presbyopia.  By clear, do you mean clear lens exchange or refractive lens exchange--an early cataract surgery?

Dr. O.

[eyedontno]

Thanks for getting back to me. I didn't receive a Dx but was told that vision was a result of hardening of the lens do to aging. I am 64 yrs old with no history of eye problems or surgeries. I was told my eyes  checked +1 and could go with either LASIK or CLEAR using Crystalens. The Dr.told me he has done LASIK on 7-8 patients my age who also had +1 reading on their eyes and they are still OK with it 5-6yrs. later but he also said that he felt that CLEAR was the best option to avoid cataract problems down the road and also  have bifocal near and far vision. I told them I would think it over. I like the idea of CLEAR because of the correction of both near and far vision w/o glasses (mostly) but I do not like the lack of a good deal of history of the product (2yrs) and when I read some of the stories of people having problems on this website  it made me lean toward the LASIK procedure. Now I am in a quandry as to which way to go. My gut tells me to go LASIK and see what happens with cataracts and deal with it then if that happens.
I'd appreciate your opinion.
Thanks!

[Ray T Oyakawa, MD]

I stopped doing LASIK on patient over 45 many years ago.  I do it on rare occasion on myopes who glare test (test for early cataract) is completely normal.

Unfortunately, as the cataract progresses, glasses are changed.  If you have LASIK, then you need enhancements as the cataract progresses.

At your age, you will need cataract surgery in the near future and LASIK will not give you good vision for more than a few years.  Then, when you need cataract surgery, it will be more difficult to calculate the correct IOL power and your cornea will have aberrations from the LASIK.  The cost now paid cash will be about the same as paying for a clear lens extraction now and the additional fee for a premium IOL when you develop a cataract.  The downside on doing it now is that technology continues to improve.  If you were my patient I would recommend doing a clear lens extraction now or just wait until you develop a cataract that the insurance will pay for (if we still have a decent Medicare in the next few years) and do a premium IOL at that time.

Dr. O.

[JodieJ]

I'll throw in some other things you might want to consider.  There has been a new Crystalens model introduced every year or two, and my impression is that the newer model is always a big improvement over what used to be.  It seems likely that there will continue to be major improvements in the technology of accommodating IOLs (what your doctor suggested using for your "clear" option).  Since you don't need cataract surgery yet, you would almost certainly have a lot to gain in terms of better vision by delaying your surgery.

I'm assuming that you're considering hyperopic LASIK to correct your distance vision.  In this case, you would still need glasses for intermediate and near vision.  And I'm wondering whether this type of LASIK might make you a poor candidate for an aspheric IOL (like the newest model of Crystalens) in the future.  In any case, you could achieve the same results as LASIK without the risk by wearing one-day disposable contact lenses.

[eyedontno]

Thank you both so much for  your valuable insight!
You both were spot on in all the salient points that I have been considering.
Dr. O, The part about "if we still have decent medicare coverage" was exactly what I was mulling over if I delayed!  It's risk but isn't most everything a risk vs. reward decision in life. You both make an excellent points about the improving technology as well.
So, it looks like I still have a choice and will mull it over this weekend and decide but the decision will be more sound, I feel, due to your valuable inputs.

Bill B.