Question: I had a corneal graft and lens replacement surgery with a lens implant to replace an opaque crystalline lens two years ago. The vision is good however I now require a +3 diopter correction axis 35 which compares unfavorably with a -1.00 D and no astigmatism in the other eye. I am tempted to seek either a revision of the replacement lens or laser surgery - even to improve if not cure! I can appreciate the risks. replacement lenses may not come out as easily as the originals and laser surgery on a graft might not be ideal - but what would you recommend?
Answer: Unfortunately there is much more clinical information needed to make a really meaningful recommendation. That said, with what you have relayed, another intraocular surgery to perform a lens exchange would not be a first recommendation-especially considering that we would suspect the astigmatism is secondary to the graft and suturing process and may not be totally regular and thus not get the best results from a lens implant for astigmatism. But we don't know enough about the astigmatism without additional testing. A less invasive, corneal surface laser eye surgery is most likely going to be able to reduce or eliminate the vast majority of the residual refractive error and do so with considerably less risk. It may not eliminate the total correction but could improve it a great deal. Your best next step is to seek the consultation of a top Laser Eye Surgeon who is also a Corneal Specialist-perhaps this is the person who performed your Corneal Transplant.
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