cataract surgery

[Normandie]

After cataract surgery, does the eye continue to age in respect to presbyopia/  In other words, if your distance has been corrected with the new implant, can you still have changes with your presbyopia whereby you will need stronger reading glasses in time?  I have the Alcon Restor Lens.  

[mira221]

Hi Normandie,
I am really curious about your experience with NanoFlex lens. Is it a positive one for the most part or a negative one?
any problems associated with it, installation was problem free?
I would really appreciate your opinion and feed back. Thanks so much , and  hope things are better with your eyes.
mira221

[John C Hagan III, MD, FACS, FAAO]

-

[Normandie]

Thank you for your recent comments.  No, I don't think I have any eye disease.  I had a good evaluation with a retina specialist before second surgery on the right eye (Nanoflex monofocal) because I didn't want to go forward with this eye without making sure there were no problems.  I do have posterior vitreous separation in both eyes with lasered tear in the right eye from accident 20 years ago, but have learned to live with the floaters from this a long time ago. With the second eye, tests included eye pathfinder analysis, so I felt that were thorough with the exam.  Hopefully, the right eye now @ 20/30 will improve for distance after the Yag.

My question regarding whether it is possible that the YAG & PRK on the Restor left eye may not correct vision was not addressed, unless I misunderstood.  Also, I guess I do not understand the concept.  I thought that Yag & PRK, if it DOES correct problem, would correct all 3 distances because the Restor lens is meant to work this way.

I will go into the archives and read as much as possible.

Again, thanks.  If you have any input you can add re: whether Yag & Prk doesn't always take care of problem, please share with me.

[John C Hagan III, MD, FACS, FAAO]

1. It is possible that your decreased vision is unrelated to the IOL and need for glasses and that you have an eye disease causing reeduced vision.
2. If your eye is nomral and glasses (no line bifocal) correct your vision to 20/20 then your problem is the power of the ReStor IOL and you need progressive bifocals when you want your best quality vision.
3. Yag capsulotomy will only help you if the capsule holding the IOL is cloudy. That is easy to determine.
4. The IOL itself can create visual problems due to "waxy vision" or dysphotopsia.

Use the search feature and archives to read the many posts about these problems on the eye forums.

I have nothing more to add.
JCH MD

[Normandie]

Dr. Hagan, you have always been so helpful when I have had questions re: Alcon Restor Lens.  Question:  I have heard of cataract patients with Restor implants who had  Yag and PRK, but it didn't resolve the problem of their poor vision.  Can this happen?  It is the reason why I hesitate to go forward and have these procedures.  With Restor Lens, if  your distance vision is only 20/40, some things 20/30, is it possible for just the Yag alone to improve this, or because distance is only 20/40, would PRK would still be necessary.  In the past you told me that if I did PRK, I would lose something, distance or closeup, depending on what we are correcting.  Is this also true with the Restor Lens, since it is meant to give all three distances in the first place.  I wish that I originally just did the monofocal lens.  This would now be all behind me.

Thanks once again for your expert input.  I wish I lived close to your practice.

Normandie    

[John C Hagan III, MD, FACS, FAAO]

I don't have time to explain presbyopia. the section on wikipedia is good. For the natural lens it is occuring all the time but it slows way down in 75+ age group.  HOWEVER myopic or near sighted individuals after middle age remove their glasses and read without glasses.  But because of presbyopia cannot see at near with single vision distance glasses. So most, me included, wear no line bifocals.

JCH MD

[Normandie]

Does presbyopia include intermediate vision?  Or does it depend on how bad your presbyopia is?  Isn't it possible to need glasses all the time for presbyopia depending on its severity.  Ex. of severity:  your hand hand 12 inches from your face is fuzzy.

[John C Hagan III, MD, FACS, FAAO]

No cataract surgery and IOL insertion ends the presbyopic process.

JCH MD