Aa
Should I risk for IOL after 24 yrs of Aphakia?
Hello all,
Let me describe my condition which is a little bit complicated: My cataract lenses was removed at the age of 6 months old but, they decided not to implant any IOL in my eyes and since then till now that I'm 24, I've been using glasses from when I wake up to when I go to bed and magnifiers for reading. Right now I'm using Windows magnifier 300x zoom. My glasses prescription is: R: +8.00 & L: +8.00 + 0.25x175. In addition, I have Amblyopia and Nystagmus (when the right eye is closed, the left one moves and can't concentrate, but when both are open, it is not that much visible). But, hopefully I am not diabetic and my eye pressure is normal. Up to now, I've visited 5 doctors who gave me somehow the same option: Monofocal IOL set for distance for both eyes + thin pair of glasses just for reading that I can get off the shelf or over the counter without prescription. Onc of them told me that after implanting the Monofocal IOL set for distance, I can then do the corneal inlay in 1 eye for my reading to completely eliminate the need for glasses. I have to mention that I don't like glasses and contacts and mono vision and thus, I don't like the idea of corneal inlay.
My questions are:
1- Do you think it worth going for the IOL after 24 yrs of using glasses? Right now, although I don't like glasses, but at least I can see with them well in near and intermediate. So want to go from the GOOD to the BEST, not from the BAD to the GOOD, which means I'm in a big dilemma.
2- Based on my eye condition, do you think there is any other way than monofocal IOL set for distance that could possibly completely eliminate the need for glasses?
3- Why my doctor did not gave me the option of Symfony? Is it RISKY in my case or completely IMPOSSIBLE? Because these two are completely different.
4- THIS QUESTION IS VERY IMPORTANT TO ME> For those of you who have implanted a Monofocal IOL set for distance, how is your near and intermediate vision? Do you need thin pair of glasses JUST FOR READING or for seeing ANY NEAR OBJECT? Do you see clearly without glasses, your face in the mirror, your watch or your cell phone to answer the calls? Do you see the edge of the lens or the holding gears or anything you haven't seen before? Do you feel it when you sleep? How does it perform in very hot weather like in sauna or very cold weather like -20c winter?
5- What do you think about corneal inlay?
Let me describe my condition which is a little bit complicated: My cataract lenses was removed at the age of 6 months old but, they decided not to implant any IOL in my eyes and since then till now that I'm 24, I've been using glasses from when I wake up to when I go to bed and magnifiers for reading. Right now I'm using Windows magnifier 300x zoom. My glasses prescription is: R: +8.00 & L: +8.00 + 0.25x175. In addition, I have Amblyopia and Nystagmus (when the right eye is closed, the left one moves and can't concentrate, but when both are open, it is not that much visible). But, hopefully I am not diabetic and my eye pressure is normal. Up to now, I've visited 5 doctors who gave me somehow the same option: Monofocal IOL set for distance for both eyes + thin pair of glasses just for reading that I can get off the shelf or over the counter without prescription. Onc of them told me that after implanting the Monofocal IOL set for distance, I can then do the corneal inlay in 1 eye for my reading to completely eliminate the need for glasses. I have to mention that I don't like glasses and contacts and mono vision and thus, I don't like the idea of corneal inlay.
My questions are:
1- Do you think it worth going for the IOL after 24 yrs of using glasses? Right now, although I don't like glasses, but at least I can see with them well in near and intermediate. So want to go from the GOOD to the BEST, not from the BAD to the GOOD, which means I'm in a big dilemma.
2- Based on my eye condition, do you think there is any other way than monofocal IOL set for distance that could possibly completely eliminate the need for glasses?
3- Why my doctor did not gave me the option of Symfony? Is it RISKY in my case or completely IMPOSSIBLE? Because these two are completely different.
4- THIS QUESTION IS VERY IMPORTANT TO ME> For those of you who have implanted a Monofocal IOL set for distance, how is your near and intermediate vision? Do you need thin pair of glasses JUST FOR READING or for seeing ANY NEAR OBJECT? Do you see clearly without glasses, your face in the mirror, your watch or your cell phone to answer the calls? Do you see the edge of the lens or the holding gears or anything you haven't seen before? Do you feel it when you sleep? How does it perform in very hot weather like in sauna or very cold weather like -20c winter?
5- What do you think about corneal inlay?
Best Answer
3 Comments
I also would not recommend corneal inlays or anything else newly available at this time. Try contacts and report back. If you can get a decent pair, your vision should be identical to what it will be after surgery. If you don't like it, you can try using a different prescription in each eye, but that's advanced. Try this first and report back. You will need a GOOD optometrist, not one of those cheap mass producing places, they won't devote the time you need. You can try calling doctors offices, and explaining your situation and see which doctor takes the time to talk to you and assure you he can help you. That's who you go see.
I like your last sentence! I am biting the internet right now! (:
First, Dr. Stein said that my vision will not become 20/20 after the surgery. Second, that's a charming thing of not needing any assistive device for reading if I wear reading glasses after surgery, but my far vision then, becomes blurry. It mean that I have to constantly put off and on my glasses, don't I? this is what makes me worried. I actually have persuaded myself to wear glasses till the last day my life and it's not a problem wearing reading glasses after surgery. Third, they told me it's gonna cost $400-500 for contacts. I actually had my first experience of contacts in the Bochner institute, but their sample lens was less than my eye's power, but it was a very brilliant experience. I felt like a free man for couple of mins. Forth, the other thing apart from all others that I have to be worried about is the determination of IOL power. I heard there is always a .05 D margin of error, even with IOL master.
First, Dr. Stein said that my vision will not become 20/20 after the surgery. Second, that's a charming thing of not needing any assistive device for reading if I wear reading glasses after surgery, but my far vision then, becomes blurry. It mean that I have to constantly put off and on my glasses, don't I? this is what makes me worried. I actually have persuaded myself to wear glasses till the last day my life and it's not a problem wearing reading glasses after surgery. Third, they told me it's gonna cost $400-500 for contacts. I actually had my first experience of contacts in the Bochner institute, but their sample lens was less than my eye's power, but it was a very brilliant experience. I felt like a free man for couple of mins. Forth, the other thing apart from all others that I have to be worried about is the determination of IOL power. I heard there is always a .05 D margin of error, even with IOL master.
oh and by the way, thanks for your time.
Inlays have an extremely poor track record. They have ended up damaging the cornea, having to be removed. Yet hope springs eternal and new companies and new surgeons bring forth another version of a poor concept. They have not withstood the test of time, they have poor track records and the follow up on the "new and improved bad idea" is short. The physician-surgeon that wrote the article on my home page blog is one of the worlds best cornea/refractive surgeons.
Dr Hagan, this is my last comment directly to you. Although I understand and appreciate your concerns regarding inlays, but, first, my question was something else which was not related to asking your opinion on inlays. I already knew that. I've read your topic here on MedHelp. Second, although I myself don't like the idea of inlays, but you should know that KAMRA, is only one the 4 types of inlays available in the market today which has the least patient satisfaction. Raindrop is another promising inlay which is both bio compatible and has high patient satisfaction. Unfortunately it hasn't been approved here in Canada, I think only KAMRA was approved. Dr. Stein told me it's gonna be approved in 2016, but till now, it hasn't been. The Dr's article in the link you provided speaks about KAMRA and as SoftwareDeveloper mentioned in your topic :http://www.medhelp.org/posts/Eye-Care/Cornea-Inlay-for-Presbyopia--NO-WAY/show/2792415
not all inlays are like KAMRA in terms of patient satisfaction.
And for the last thing, I wish and hope you never get so desperate in your life that you need to beg info bit by bit from people and as Hafez wishes:
"In need of the physician’s care, thy body be not;
Vexed by injury, thy tender existence be not!"
not all inlays are like KAMRA in terms of patient satisfaction.
And for the last thing, I wish and hope you never get so desperate in your life that you need to beg info bit by bit from people and as Hafez wishes:
"In need of the physician’s care, thy body be not;
Vexed by injury, thy tender existence be not!"
Thank you for your time chazas. Your experiences for me are valuable.
There is a simulator of post IOL vision in this website:
https://www.mylifestylelens.com/premium-intraocular-lens-simulator/
Would you please take a look at it and tell me how much their simulation is correct and near to reality with your IOL implanted eye?
If the link didn't work please take a look at these 2 images I've uploaded:
http://8pic.ir/images/wbu6g0ifou38fk7008ck.jpg
http://8pic.ir/images/vpsffunarbnzjzaiwfa9.jpg
Both of them are simulation of mono focal IOL set for distance. In the second one, the guy is not even able to read the dash board but sees the street. Is it really like that with a standard far vision IOL?
Thanks again.
There is a simulator of post IOL vision in this website:
https://www.mylifestylelens.com/premium-intraocular-lens-simulator/
Would you please take a look at it and tell me how much their simulation is correct and near to reality with your IOL implanted eye?
If the link didn't work please take a look at these 2 images I've uploaded:
http://8pic.ir/images/wbu6g0ifou38fk7008ck.jpg
http://8pic.ir/images/vpsffunarbnzjzaiwfa9.jpg
Both of them are simulation of mono focal IOL set for distance. In the second one, the guy is not even able to read the dash board but sees the street. Is it really like that with a standard far vision IOL?
Thanks again.
This will be my last comment on this discussion. I discussed this in my article which is linked above. There is no "one size fits all". Some people like Software Developer are very happy with their surgery and posts same. Other people are miserable and sorry they had their surgery. Some people are happy not needing glases for driving while others complain this comes at the expense of not being able to read without glasses.
Dr. Hagan, just a question:
What is your opinion on setting the iol for close and intermediate in both eyes; so that I use the thin pair of glasses only for when I drive? I mean, is a better option than setting the iol for distance and implanting Ranidrop for close vision?
I thought with myself that 1- I am used to having good near vision for about 23 yrs and 2- I need my near vision more than far.
In the meantime I'm trying to have an appointment with my Dr. I hope they give me the appointment.
What is your opinion on setting the iol for close and intermediate in both eyes; so that I use the thin pair of glasses only for when I drive? I mean, is a better option than setting the iol for distance and implanting Ranidrop for close vision?
I thought with myself that 1- I am used to having good near vision for about 23 yrs and 2- I need my near vision more than far.
In the meantime I'm trying to have an appointment with my Dr. I hope they give me the appointment.
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.
If you have IOL's set for distance, and your distance vision is then 20/20, at intermediate, you'd require one and half diopters correction. If you chose not to use it, each half a diopter removes approximately one line of vision. So your vision should still be 20/50. To be safe, lets say 20/60. At near, you'd be off 2.5 diopters, or 20/70, lets say 20/80. Is your current near vision really that much better than 20/80 wearing only your distance glasses and no magnifier? There is a reason why everyone has an IOL implanted.
If there are no complications, I cannot imagine that you would be worse off than you are now at any distance, even assuming that you are in the group that has the worst vision at multiple distances after a successful cataract surgery. Medicine can't promise you no glasses, but they can promise much better vision than you have now. Given your history, I would recommend using regular monofocals, and not going to multifocals or anything else new fangled. You had congenital cataracts ,which means its possible that your visual system didn't develop normally because your brain wasn't receiving clear input. This slight disability could become a serious issue if you had to deal with the reduced contrast sensitivity and quality of vision you'd have with multifocal IOL's or current accommodating options.
Now, there is a way to run a test. Go find yourself a good, patient optometrist, and get yourself a pair of single vision contacts for distance. They do make brands for aphakic people, I think one is called silosoft if I remember correctly. You also have a fairly low prescription (if you didn't have cataracts ,you would have been extremely nearsighted and needed thick glasses anyway) so you may be able to use normal brands too but I am not sure. This should be approximately what your vision will be like with monofocal IOL's, except with IOL's you may occasionally catch a reflection around the edge, but your vision should be the same. If your distance vision is not 20/20 in contacts, it wont be with IOL's either. But your prescription is only a +8.00, so contacts should be really close (at all distances) to what you'd have after surgery. Try that, and then decide to keep wearing contacts, have the surgery with monofocals for distance, or if you're unhappy, then you can keep beating your head against the wall on internet forums looking for a better solution.