Aa
measurement for IOL
Good morning .. recently had cataract removal and replacement with lenses for 'distance' only. they are Alcon Acysof IQ...i am seeing fantastic insofar as distance and tested 20/20 in both eyes! ( I will be getting glasses for intermediate and close range).
here's my question:
each lens (was given an 'owners card) shows a different number. One eye shows 15.5 D - other is 16.5 D -letters are SN60WF.... useing both eyes 'together' as i said my distance is great but out of curiosity when i held my hand over each eye the left eye with the 'higher' number (16.5D) seems a 'tad' sharper than the R-eye with 15.5D.
Is this an 'error' in the measurments? Should ' both' implants have been either 15.5D or 16.5D.(same for each eye) ... could the fact that i am still on after-surgery drops (antibiotic/inflmamation/steriod) play a factor ? Appreciate any input.
here's my question:
each lens (was given an 'owners card) shows a different number. One eye shows 15.5 D - other is 16.5 D -letters are SN60WF.... useing both eyes 'together' as i said my distance is great but out of curiosity when i held my hand over each eye the left eye with the 'higher' number (16.5D) seems a 'tad' sharper than the R-eye with 15.5D.
Is this an 'error' in the measurments? Should ' both' implants have been either 15.5D or 16.5D.(same for each eye) ... could the fact that i am still on after-surgery drops (antibiotic/inflmamation/steriod) play a factor ? Appreciate any input.
Dr. Hagan:
All that you have written,described, explains definitely sums it up for me !!! now i understand the 'mechanics' a little better... right now besides the 'long-distance' being wonderful, i notice as time is progressing that i'm able to see 'somewhat' in what i call 'midrange' !!! (who knows if i'm correct in my 'preception' of 'mid-range'... - ''a little 'closer' than the far-side of a large room or into the horizon)... but i definitely will need correction with glasses for computer work and of course close reading... and while i wasn't driving at night for years i may give it a try now that jodie is comfortable with it also... right now i'm just amazed at 'what' i'm able to 'see' !!
Thank you both very very much for your replies !
All that you have written,described, explains definitely sums it up for me !!! now i understand the 'mechanics' a little better... right now besides the 'long-distance' being wonderful, i notice as time is progressing that i'm able to see 'somewhat' in what i call 'midrange' !!! (who knows if i'm correct in my 'preception' of 'mid-range'... - ''a little 'closer' than the far-side of a large room or into the horizon)... but i definitely will need correction with glasses for computer work and of course close reading... and while i wasn't driving at night for years i may give it a try now that jodie is comfortable with it also... right now i'm just amazed at 'what' i'm able to 'see' !!
Thank you both very very much for your replies !
You might experience another benefit from your aspheric IOLs: improved night driving ability. The difference is subtle but seems to be real, at least for me. I had always hated driving to my sister's house at night; those dark, winding suburban roads made me nervous. But with my AcrySof IQs, it's no longer a problem. (The Tecnis lens offers the same benefit.)
BTW, a little residual astigmatism is not always a bad thing. One of my eyes is slightly farsighted (+.25D) and the .5D of residual astigmatism actually improves my vision.
BTW, a little residual astigmatism is not always a bad thing. One of my eyes is slightly farsighted (+.25D) and the .5D of residual astigmatism actually improves my vision.
MEDICAL PROFESSIONAL
The short answer is the same power and model in an eye will not necessarily leave the eye with the same vision or refractive error.
This is a longer answer from a recent post:
Hello Garrett, Your mother's optical situation is not uncommon. Choosing an intraocular implant (IOL) power to give the best vision unaided by glasses is as JodieJ says not an exact science. It is much, much better than 5-10 years ago and it will be better 5-10 years from now. It will never be 100%. Like much of medicine we are sometimes a victim of our own success. There was a time in which patients were happy to go through a cataract operation without a major complications and wore regular glasses happily after surgery.
As we have been able to improve the vision without glasses some people expect to see perfect without glasses even though this is not possible for many people and something an ethical surgeon never promises or guarentees. There are many variables (radius of curvature of the cornea, axial length of the eye, position of the IOL in the eye, etc) that can cause the actual result of surgery to differ from the "theoretical" values used in the pre-operative calculations. There is not even one forumula that surgeons agree is "best" to use for the calculations. As eyes become longer than normal or shorter than normal the possibility of under/over correction increases significantly.
Some eyes, because of astigmatism, are not correctable with the standard monofocal implants used in most surgeries. Even with the new multifocal "premium" IOLs that are used to try and get away from glasses completely for all distances often require glasses for certain tasks and certain distances (use the search feature and look at all the complaints).
Of course it is possible to have gross miscalcuations due to error in data acquisition or data entry. These are rare compared to the normal "scatter".
Wearing progressive bifocal lens to achieve good vision is the expected and hoped for result of standard monofocal IOL surgery. Some people will see satisfactory at distance without glasses, others will see okay at near or mid range without glasses but this is a bonus not the expected result. We never tell our patients that they will be able to go without glasses. We tell them it often happens but we expect they will need glasses. Period.
There are certain circumstances in which if the difference is way to much to wear glasses (say a 4-5 diopter difference) that the information can be sent to a Medicare review or insurance review committee to authorize a LASIK procedure and have it paid for by insurance/Medicare (of course deductibles or co-payments would legally have to be collected). If glasses are feasible and wearable do not expect them to authorize the LASIK.
As to your physician's behavior, again Jodie J may be right. If you've gone to this ophthalmologist (Eye MD) for quite some time and he/she is generally even tempered and patient, I would cut them some slack. On the other hand if the physician is usually this way then I would seek not only a second opinion but a new ophthalmologist. I am a very patient physician and very even dispositioned but I have "lost it" on a few occassions with my patients. I always felt terrible afterwards and in most cases have called back to apologize the next day. More than one of these occured during a stretch where in addition to my professional responsibilities I was taking care of a sick parent and another member of my family was seriously ill.
Compared to some of the really serious sight threatening complications that are often posted here I think your mother has some really excellent options.
JCH MD
This is a longer answer from a recent post:
Hello Garrett, Your mother's optical situation is not uncommon. Choosing an intraocular implant (IOL) power to give the best vision unaided by glasses is as JodieJ says not an exact science. It is much, much better than 5-10 years ago and it will be better 5-10 years from now. It will never be 100%. Like much of medicine we are sometimes a victim of our own success. There was a time in which patients were happy to go through a cataract operation without a major complications and wore regular glasses happily after surgery.
As we have been able to improve the vision without glasses some people expect to see perfect without glasses even though this is not possible for many people and something an ethical surgeon never promises or guarentees. There are many variables (radius of curvature of the cornea, axial length of the eye, position of the IOL in the eye, etc) that can cause the actual result of surgery to differ from the "theoretical" values used in the pre-operative calculations. There is not even one forumula that surgeons agree is "best" to use for the calculations. As eyes become longer than normal or shorter than normal the possibility of under/over correction increases significantly.
Some eyes, because of astigmatism, are not correctable with the standard monofocal implants used in most surgeries. Even with the new multifocal "premium" IOLs that are used to try and get away from glasses completely for all distances often require glasses for certain tasks and certain distances (use the search feature and look at all the complaints).
Of course it is possible to have gross miscalcuations due to error in data acquisition or data entry. These are rare compared to the normal "scatter".
Wearing progressive bifocal lens to achieve good vision is the expected and hoped for result of standard monofocal IOL surgery. Some people will see satisfactory at distance without glasses, others will see okay at near or mid range without glasses but this is a bonus not the expected result. We never tell our patients that they will be able to go without glasses. We tell them it often happens but we expect they will need glasses. Period.
There are certain circumstances in which if the difference is way to much to wear glasses (say a 4-5 diopter difference) that the information can be sent to a Medicare review or insurance review committee to authorize a LASIK procedure and have it paid for by insurance/Medicare (of course deductibles or co-payments would legally have to be collected). If glasses are feasible and wearable do not expect them to authorize the LASIK.
As to your physician's behavior, again Jodie J may be right. If you've gone to this ophthalmologist (Eye MD) for quite some time and he/she is generally even tempered and patient, I would cut them some slack. On the other hand if the physician is usually this way then I would seek not only a second opinion but a new ophthalmologist. I am a very patient physician and very even dispositioned but I have "lost it" on a few occassions with my patients. I always felt terrible afterwards and in most cases have called back to apologize the next day. More than one of these occured during a stretch where in addition to my professional responsibilities I was taking care of a sick parent and another member of my family was seriously ill.
Compared to some of the really serious sight threatening complications that are often posted here I think your mother has some really excellent options.
JCH MD
thank you both very much for replying - you have definitely relieved my mind - and yes, i when i wore glasses i was corrected for astigmatism(which was not corrected during surgery0 so i guess the combo of 'recovery-period/drops/not yet corrected asigmatism' is playing a factor in my situation but as i said just 'seeing' at a distance is amazing. Thank you both so very much !!!
By the way, i started also to notice ''occasionially' on one eye only - at the peripheral area of my left eye a little 'whitish' cloud-like substance that drifts in/out -- as if someone were approaching me from behind ..it's slow moving & then disappears not to return during the same 'period of time' but still startles me... not constant... but this just started a few days ago - but it was not apparent immediately following my first post-operative appointment ... i was checked thoroughly by the opthalmologist and see him again 2 weeks.
Again, many thinks.
By the way, i started also to notice ''occasionially' on one eye only - at the peripheral area of my left eye a little 'whitish' cloud-like substance that drifts in/out -- as if someone were approaching me from behind ..it's slow moving & then disappears not to return during the same 'period of time' but still startles me... not constant... but this just started a few days ago - but it was not apparent immediately following my first post-operative appointment ... i was checked thoroughly by the opthalmologist and see him again 2 weeks.
Again, many thinks.
And, of course, you could have some residual astigmatism left, that those IOL's will not correct. I have the same lenses and I had a similar complaint with my optometrist and he replied, that he hadn't corrected for the 0.5D astigmatism in my reading glasses because he figured it wouldn't matter - and it doesn't really, but I noticed it anyway.
Congratulations on your excellent outcome. Yes, the drops can blur your vision. As I recall, it took a few weeks for my vision to stabilize--so wait awhile longer before judging. It's quite possible that two eyes with the same pre-surgery script would need a different IOL power--mine did. BTW, a 15.5 lens is actually stronger than a 16.5.
Have an Answer?
You are reading content posted in the Eye Care Community
Top General Health Answerers
Kansas City, MO
Grand Prairie, TX
San Diego, CA
Discharge often isn't normal, and could mean an infection or an STD.
In this unique and fascinating report from Missouri Medicine, world-renowned expert Dr. Raymond Moody examines what really happens when we almost die.
Think a loved one may be experiencing hearing loss? Here are five warning signs to watch for.
When it comes to your health, timing is everything
We’ve got a crash course on metabolism basics.
Learn what you can do to avoid ski injury and other common winter sports injury.
