Cataract high myopic post PhakicIOL

[LesEye]

I am 41 and have recently had Phacik IOL in both eyes.  My original Rx was about -23 in both eyes with high astigmatism (-5 and up).  Both implants were at the max -20.  The first (Mar '07) was quite successful and my over correction glasses are -2.0 with -2 astigmatism - resulting in about 20/45-50 VA (using no glasses for reading and computer).  The second eye (9/25/07) was not as successful and a month later I have developed a cataract that is forming fast.  My doctor has recommended removing natural lens and IOL and replacing with a corrective lens.   I have worn glasses since age 3 then contacts and gas perm for 20+ years.  I have never seen at 20/20 but was pretty functional (driver's lisence and all) I live in NYC and don't depend on a car, but want the best vision I can get.  I prefer glasses +/or contacts to lasik and had originally planned to go with contacts for distance with reading glasses after the IOLs.  I am going for a second opinion on the cataract and maybe another specialist for ideas on what type of lens to implant.  I have the basics on the types and brands of lenses.  I have already laid out a lot of out of pocket money on the implants, so I am hoping to go with whatever is covered by my insurance, but that may mean limiting my choices significantly.  If another lens really seems best than I will find a way to cover that too.  I seem to be losing more vision with each passing week and have a tentative surgery date of Dec 11, 2007.   Any advice will be helpful.  Also NYC Dr info if I need more cunsultations.

[James J Salz, M.D.]

Your main risk now is the increased possibility of developing a retinal detachment after your natural lens is removed.so you want to have a thorough retinal exam by a retinal specialist before you have the cataract surgery.  He will telll you if there are any weak areas in your retina that should be pre treated with a laser before the catarat surgery.  The odd are very high that you will do well and get normal vision but your risk of a retinal detachment during your life time are already much higher than nrormal because of your high myopia and they become even higher if you have the cataract removed.  Even with that being said, chances are you will do fine and obtain excellent vision. As far as the implant, you reallly don't have to worry because you won't be able to have any of the new multfocal lenses as they won't be able in your power so don't even worry about that part.  So the cost of the surgery should be covered by your insurance.  I can suggest Dr. Richard Mackool or Dr. Eric Donnefeld in the New York area and you are wise in getting more than one opinion. Good luck and most likely you will end up with the best vision you have had during your entire life.
JS

[LesEye]

A related discussion, 1 year later was started.

[dimple17]

A related discussion, regarding macular was started.

[LesEye]

Thanks for the info - very helpful