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[barca99]

I am interested in the forums doctors and experienced eye professionals opinions as to possible options for my eye condition.

Almost a year ago I suffered blunt trauma to my eye (a bungee cord - throw them away now if you have got any). It left me with a mydriatic pupil, angle recession and a traumatic cataract. The cataract is getting worse and I will need surgery in the next year or two. Pressure was OK 3 months ago. I will be checked again in May. My retina is OK so I am hoping that with a sensible surgical approach I should get a reasonable level of vision from the eye.

In bright light the pupil closes to about 4 mm across, this is OK now because the cataract reduces the light into the eye. When inside the pupil is about 3-4 mm larger than my good eye. I am more bothered by the loss of vision quality and glare issues than the cosmetic difference associated with the pupil. However if both could be improved I would be happiest. I am 38 and my other eye is fine apart from some floaters.

I've read about cosmetic contact lenses, pilocarpine, iris cerclage sutures, iris implants and aniridic IOLs.

Are there any other options?

My thoughts now are a fixed focus IOL set for intermediate and glasses with a varifocal lens that darkens in sunlight. I believe this would be the most conservative approach; it may not result in the best possible vision and would still leave me with glare problems. This leaves me wondering if when cataract surgery is required something more advanced could be considered.

What would the experts on this site recommend for a patient with these issues?

Thanks.

John.

[flatsy]

i had a cararact removed  from my eye with tramatic mydriasis(20 yr. old injury).due to excessive glare, my dr. is now  scheduling iris cercluge.  isnt that performed at the time of cataract surgery, and will my new lense have to now be replaced?

[Ray T Oyakawa, MD]

Iris cerlage is sutures completely around the pupil if is dilated symmetrically.  Suturing is for an irregular section to make it round.

Crystalens would allow near vision.  This would work better with your other eye which still accommodates.

Dr. O.

[barca99]

Thanks for your reply. Sorry, three more questions.

What is the difference between iris cerclage and suturing?

What would the benefit of Crystalens be?

Is this what most patients with my symptoms would have done?

Thanks

John.

[Ray T Oyakawa, MD]

Iris cerclage or suturing, but not too small or view of the retinal will be compromised.

Also, consider Crystalens.



Dr. O.