Cataract surgery after Lasik

[Candace888]

Hi,
I am wondering if anyone has had cataract surgery after having had Lasik done.  I had lasik done 13 years ago and it has been wonderful.  Unfortunately, 6 months ago I had a severe Retinal Detachment, Scleral Buckle and Oil.  The oil is now out and my retina is holding.  I have a very bad cataract that I will be having surgery for on 7/8.  The retinal doctor has not released me yet but did have me see the Opthamologist who will be doing the catarct surgery.  He has seen me once and all he said is that it will be tricky to calculate the prescription for the lens implant, also my cornea is very thin.  Any one have a similar experience and how did it come out?  Anything I should know or ask the doctor about now?   He told me that he will do his very best to calculate it correctly to get the best possible vision for me but there are no guarantees.  

[Candace888]

Hi Dr. O,

Thank you VERY much for that information.  I will print this out and take it with me to my next visit.  I do have records of the Lasik and my eye doctor said that the Lasik doctor had kept impeccable records.  He was talking about having a Corneal Topography and IOL study done at another doctor's office but cancelled it and told me that he had decided on a different route.  I see him on 6/21, so I will take your info with me.  Thanks again!

[Ray T Oyakawa, MD]

Yes,  There is a formula Holladay II that many doctor do not use due to its cost that can calculate the correct IOL.  You now have two variable, the scleral buckle and the cornea.  You need to find a doctor who does both LASIK and cataracts or a cataract surgeon who has all the tools.

It would be helpful if you have your pre LASIK data, if not you need a alternate method to determine the corneal power such as the Pentacam or RTVue corneal power module.

I had the same situation.  However, I had all my pre PRK data.  I used the Holladay II and used my historical data (previous PRK) and used the scleral buckle formula to determine my IOL power.  I also used the RTvue corneal power instead of the historical data for a third calculation.  Then I used Haigis L (IOL Master) to determine  another calculation of IOL power for post refractive eyes.  I fudged this IOL power by looking at how much the IOL power changed in Holladay II with the scleral buckle formula checked and unchecked.  I had three calculations of IOL power that all recommended the same power.  I ended up within 0.25 Diopter of calculation.

Good luck.

Dr. O.