toric icl

[Mreman]

Hey, my doctor said im not suitable for lasik or epi-lasik  or any kind of laser surgery because i have really dry eyes and sensitive eyes. I really want to get my astigmatism corrected and it looks like the only way is to get the toric icl, I'm not really sure if they make my power (right= sph -1.00 cyl -1.5 axis20 and left= sph 0.00 cyl -2.00 axis 170) i mainly have astigmatism is it possible to get an icl for just astigmatism n bit short sightness for my right eye? Also is icl safe, or safer then laser treatment? And whats the youngest i can get it done? really appreciate your responses:)

[JodieJ]

I had limbal relaxing incisions, and they did not worsen my dry eyes.  (My eyes were somewhat dry before and somewhat dry after--no noticeable change.  I could still wear contacts comfortably.)

One more suggestion:  ask about PRK (another refractive procedure).  It's reputed to be better than LASIK for people with dry eyes.  It's supposed to be more reliable than limbal relaxing incisions for correcting astigmatism.

If you leave your right eye nearsighted, most of your friends your age will be needing reading glasses before you do when you reach your 40's.

[Mreman]

Thank you both for your responces, all that really bothers me is my astigmatism, not the little amount of shortsightness in my right, i'm really thinking limbal relaxing incisions just want to ask you Doctor, is there any chance at all of my current dry eye worsening after Limbal relaxing incisions? Or any other serious complications with it? thanks alot

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

You know you don't have that much astigmatism, I would get a second opinion about LASIK  or a limbal relaxing incision.

JCH MD

[JodieJ]

Limbal relaxing incisions are usually done to reduce astigmatism at the time of cataract surgery.  The only contradiction that I'm aware of is having thin corneas.  It might be best for you to consult an ophthalmologist who does both cataract and refractive surgery.  It's my impression that the procedure is very safe if performed by an expert.  With good results, you'd probably be able to function without glasses or contacts in most situations.

I hope that Dr. Hagan reviews this thread so he can give you professional advice about whether this option might work for you.  

[Mreman]

Wow thanks for ur suggestions jodie , i'm really interested in the limbal relaxing incisions, but i'm not sure if it will  affect my dry eye? Also do you know the risks and complications of the procedure? thanks for your help:)

[JodieJ]

Have you tried consulting an optometrist who specializes in fitting contacts for "hard-to-fit" patients?  There are several options available for people with dry eyes and astigmatism (including 1-day disposable toric contacts) that might work for you.  If there is an optometry school in your area, they could probably give you referrals.

I'm not very knowledgeable about refractive surgery (i.e., LASIK, etc.), but given your strong desire to avoid glasses it might be worth your time to consult another ophthalmologist who specializes in refractive procedures.  You might be a candidate for limbal relaxing incisions (a quick, relatively inexpensive in-office procedure) to reduce your astigmatism.  This might allow you to get good vision by wearing a regular contact (which is thinner and more comfortable than a toric lens) in your right eye only.  (You'd probably be able to drive without glasses or contacts.)  You'd still be slightly nearsighted, but this would be an advantage when you reach your 40's.    

[Mreman]

Thank you for your reply, i only considered icl because i thought it would be a suitable alternative to laser surgery which is too risky for my dry eyes, im thinking not to get icl done after your reply, but i'm running out of options and i'm despret for alternatives, i cannot wear regular contacts due to dry eye and i'm depressed with the vision i get with my glasses. Can you please suggest other alternatives to correct my vision safely? Much appreciated

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

I do not recommend intraocular contacts to my patients. Recent studies have identified problems including: cataracts and damage to the cornea endothelial cells.

I would never have one of these put in my eyes or members of my family.

JCH MD