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Timing to replace an IOF
40 year old male. About 12 years ago I had lasik done in both eyes. 4 weeks ago I had cataract lens replacement in my left eye done by the same surgeon who did the Lasik. She did an excellent job, my eye feels great. Unfortunately, I can’t see at any distance. Everything is blurry.
The power of this lens is not correct and I definitely need to have it replaced. She said that I need to give it another 2 or 3 months to let the eye heal.
I went to get a second opinion. He said the eye looks good and reiterated that due to the Lasik it’s difficult to get the exact result desired. I understand this. He did say specifically that if I chose to extract the current IOL and replace it, I should do it within 2 months of the original surgery. He said that after 2 months the current IOL would harden and that would make extraction much more difficult.
Both surgeons have done thousands of these procedures and I trust both of them, but I am very concerned by this discrepancy in time. Should I wait the 2 or 3 months to have the IOL replaced or do it as soon as possible? It’s been a month already and I don’t see any improvement in the eye.
The power of this lens is not correct and I definitely need to have it replaced. She said that I need to give it another 2 or 3 months to let the eye heal.
I went to get a second opinion. He said the eye looks good and reiterated that due to the Lasik it’s difficult to get the exact result desired. I understand this. He did say specifically that if I chose to extract the current IOL and replace it, I should do it within 2 months of the original surgery. He said that after 2 months the current IOL would harden and that would make extraction much more difficult.
Both surgeons have done thousands of these procedures and I trust both of them, but I am very concerned by this discrepancy in time. Should I wait the 2 or 3 months to have the IOL replaced or do it as soon as possible? It’s been a month already and I don’t see any improvement in the eye.
Dr. O,
I will speak to the doctor who did the original surgery. However, she has already made it clear that she is not willing to do it sooner. So I may have to go to the second surgeon to do this replacement. I'm waiting to hear back from my insurance to see what would be covered. Believe me I would much rather get this fixed now, but my surgeon is not making this easy.
I will speak to the doctor who did the original surgery. However, she has already made it clear that she is not willing to do it sooner. So I may have to go to the second surgeon to do this replacement. I'm waiting to hear back from my insurance to see what would be covered. Believe me I would much rather get this fixed now, but my surgeon is not making this easy.
MEDICAL PROFESSIONAL
It is easier to do earlier. The numbers will not change at this time.
All you need is your vision with out correction and the vision with your manifest refraction. Ask your doctor's staff.
Dr. O.
All you need is your vision with out correction and the vision with your manifest refraction. Ask your doctor's staff.
Dr. O.
Dr. O, I don't claim to know what numbers went in to the calculation or what formulas were used. I trusted that since she did the Lasik she would get the calculation correct.
It's very disconcerting to assume that she is stalling just to get a bigger reimbursement knowing that I am having a difficult time seeing anything out of my left eye. However, my main concern is that I am not hurting myself by waiting, thereby making the surgery higher risk?
Many Thanks.
It's very disconcerting to assume that she is stalling just to get a bigger reimbursement knowing that I am having a difficult time seeing anything out of my left eye. However, my main concern is that I am not hurting myself by waiting, thereby making the surgery higher risk?
Many Thanks.
MEDICAL PROFESSIONAL
The calculation depends on the adjustment to corneal power due to the LASIK. The power of the cornea after LASIK needs to be calculated. Some machines will evaluate the power. Also, formulas such as Haigis L is fairly good in the calculation. The ASCRS website has a number of formula to use in post refractive patients.
Dr. O.
Dr. O.
It's the Alcon AcrySof SN60WF 18.0 which I believe is a single piece IOL to answer Dr. O's question.
Per the calculations that she showed me, I needed a 17.76 diopter.
But since these IOL's don't come in 0.25 intervals she used an 18.0
It turns out what I needed, per the current eye test, was a 16.0
Per the calculations that she showed me, I needed a 17.76 diopter.
But since these IOL's don't come in 0.25 intervals she used an 18.0
It turns out what I needed, per the current eye test, was a 16.0
Do you know what diopter you and your cataract surgeon targeted?
Do you know what diopter you actually ended up with ?
Do you know what diopter you actually ended up with ?
MEDICAL PROFESSIONAL
It depends on the IOL. Most surgeon use a single piece IOL and they can be exchanged even after three months. There could be a billing issue. A second surgery within 3 months is considered in the post operative period and the reimbursement for the IOL exchange is less. If you have an IOL power error I would tend to exchange in much earlier.
Dr. O.
Dr. O.
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