Monday, August 29, 2011

LASIK for Blurry Far Vision with Multifocal Lens Implant

Question: I have a question about LASIK Surgery for distance vision correction after a ReSTOR® Multifocal Lens Implant. I had a ReSTOR® Mutifocal lens put in my left eye 3 weeks ago. My intermediate and close vision is good, but far distance is very blurry. I have put off doing the right eye because of this. If I have the right eye done will they sync up and I will be able to see at a distance better? Would LASIK Surgery help with seeing better at a distance. I understand that it takes several months for brain and eyes to learn to work together. Am I expecting too much too soon. Would it be better to go ahead and do the other eye now?


Answer: In general patients having ReSTOR® Multifocal Lens Implants see pretty well at distance shortly after their surgery. The fact that you describe your distance vision as "very blurry" is a bit of a concern. There are several things to consider in concert with your Cataract Surgeon.

First, the nature of the optical design of the ReSTOR® lens does in fact cause some small number of patients to have difficulty with their distance vision-in some cases it gets better and in others is does not. They also sometimes experience a "smudge" in their vision or what they perceive as blurriness due to a disturbance in their contrast sensitivity from this type of Lens Implant. This type of optical problem usually goes away after a month or so and if it does not and it is the only reason for the reduced vision at distance may warrant exchanging the lens if it is that disturbing. LASIK Surgery would not be of any help in this situation. You also state that your intermediate and distance vision are in fact good. There is a possibility that you may be slightly overcorrected at distance which is causing the far vision blur and making the near and intermediate a bit "too good". Your Cataract Surgeon should be able to easily measure the refraction of your eye and determine whether this is the case. If it is the case there are several options including a) the ReSTOR® can be exchanged for a different power which requires another intraocular surgery b) wearing a mild eyeglass prescription for seeing at distance or c) as you have questioned, depending on the degree of correction to be altered you could be a candidate for a LASIK Surgery to achieve the desired distance vision. BUT-all of these options and their timing should be guided by you Cataract Surgeon IF and only if there is indeed a small residual refractive error that needs to be corrected. It is absolutely worth exploring this with your surgeon and if you do not get a satisfactory explanation and plan then consider seeking a second opinion with a top Cataract and LASIK Surgeon in your area.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on www.seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of www.seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Friday, August 19, 2011

Focusing Lens Implants to Replace Old Implant?

Question: Has there been any research in the replacement of older lens implants with the new focusing lens implants?


Answer: If you have already had a Lens Implant some time ago using a basic monofocal design for seeing at distance and now wish to replace it with either an accommodating lens implant, such as the Crystalens® Accommodating Lens Implant, or a multifocal lens implant such as the ReSTOR® Multifocal Lens Implant or the Tecnis™ Multifocal Lens Implant, you will be quite limited in what is possible. A Lens Exchange of this type is an exceedingly complex surgical procedure that significantly increases the risk of complications and decreases the overall likelihood of success with the focusing or multifocal lens implant. While it is perhaps possible to do, this the general consensus among top Refractive Cataract Surgeons is that they are not at all anxious to offer this as an option to patients.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on www.seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of www.seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, August 16, 2011

Astigmatism and Cataract Surgery

Question: I have a question about astigmatism correction with eyeglasses and cataract surgery. I am facing cataract surgery have some astigmatism and do not wish to use the special toric lens implant. Will eyeglass correction for astigmatism provide the same result?


Answer: For patients having Cataract Surgery who have preexisting astigmatism, it will need to be corrected in order to get the best possible vision after their Cataract operation. There are three primary methods of correcting astigmatism for Cataract patients. These include astigmatism correcting toric lens implants, Limbal Relaxing Incisions (LRI) and eyeglasses. Another alternative is Laser Eye Surgery such as LASIK however with the popularity of toric lens implants this is not used much anymore. Each method has its own advantages and disadvantages. Astigmatism correcting lens implants probably provide the most normal and natural vision correction as they are placed right in the eye-they do cost a little more but generally provide very good vision such that patients typically no longer need to wear eyeglasses to see at distance after Cataract Surgery. Limbal Relaxing Incisions (LRI) can also be used to correct astigmatism but perhaps with a slight bit less precision than the Lens Implants. Astigmatism correction in eyeglasses after Cataract Surgery generally provides excellent vision correction-equivalent to toric lens implants-but does require the wearing of glasses to see clearly and thus creates the same inconvenience, reflection issues and barriers as any other eyeglass prescription.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, August 9, 2011

LASIK Recovery and Sunglasses

Question: My 22 year old daughter is nearsighted with astigmatism wants LASIK surgery as she says the weight of her glasses frames gives her a headache. She says she can only do this in the winter as you have to wear sunglasses for a long time if you do it in the summer. Is she correct? Could she have LASIK without wearing sunglasses for a long time?

Answer: On general the recovery from LASIK is actually quite quick. The vast majority of LASIK patients typically experience mild grittiness and minor irritation for up to a couple of days after their treatment and some experience mild to moderate light sensitivity-however it is not typical for patients to have to wear sunglasses for prolonged periods of time. That said, the wearing of sunglasses for protection from UV light is a healthy and important practice for patients whether they have LASIK or not. The notion of winter treatment being preferable because there is less UV light is really not relevant as one also should strongly consider sun protection in the winter months. Your best next step is to schedule a consultation with a top LASIK Surgeon in your area and first and foremost determine whether your daughter is indeed a good candidate for LASIK or any type of Laser Eye Surgery for the vision correction.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, August 8, 2011

Extreme Myopic Laser Eye Surgery

Question: I wear -20.00 D power contact lenses. Am I a candidate for Laser Eye Surgery such as LASIK?


Answer: LASIK and other types of Laser Eye Surgery such as PRK are useful for correcting moderate and some degrees of high myopia. At -20.00 D you would be classified as extreme myopia. Most currently FDA approved excimer lasers for LASIK allow a maximum correction of -10.00 D-12.00 D with any degree of precision. In addition the real limitation is not actually just the laser programming but more importantly that Laser Eye Surgery for Laser Vision Correction is a "subtractive" procedure in that it removes tissue. It is highly unlikely that there would be enough corneal tissue to safely and predictably remove enough tissue to achieve a -20.00 D correction.

Depending on your age and the overall health of your eyes more appropriate choices might be the Visian ICL™ Implantable Collamer Lens or perhaps Lens Replacement Surgery. Your best next step is to schedule a consultation with a top LASIK Surgeon who is also a full scope Refractive surgeon and also performs Lens Implants and Lens Replacement procedures.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Thursday, August 4, 2011

Age and LASIK Surgery

Question: I am 68 and have no sign of Cataracts. Would LASIK work for me?


Answer: Age is not a limiting factor for having LASIK Surgery. If you are in good overall health, your eyes are healthy, free of Cataracts as you state and you meet the other requirements for LASIK including adequate healthy tears, normal corneal shape, thickness and health and wish to less dependent or perhaps independent of eyeglasses for seeing far away then LASIK is a possibility for you. Your next step is to schedule a consultation with the best LASIK Surgeon in your area so that he or she can provide the necessary testing and counsel to make sure this is your preferred vision correction option.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Wednesday, August 3, 2011

Success Rates with Monovision LASIK

Question: I am over 60 years old and have been nearsighted almost all my life. I wear monovision contacts and have for many years. I am considering LASIK surgery and was told about 25% of patients try monovision surgery LASIK and about 10% of them are not happy with it. What are your views.

Answer: Our views regarding the success rate of monovision LASIK are much less significant than the actual published literature on the matter. The most recent carefully conducted study reported that about 28% of patients who had monovison LASIK elected to have an enhancement in order to neutralize the monovision effect. However, this was NOT in a population of previously successful monovision contact lens wearers. In a population of already adapted monovision patients who are successful, the dissatisfaction rate is likely to be MUCH lower and be in the single percentages at highest. The 28% dissatisfaction with LASIK is consistent with many other previous studies and so we believe it to be reliable. The fact that do well with monovision contacts bodes well for your success with monovision LASIK. The only question you need to consider is whether you have even the beginning of Cataracts in which case you should not have LASIK Surgery but should consider Lens Replacement Surgery which will address any newly forming Cataract, your nearsightedness and your need for help seeing up close.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, August 2, 2011

LASIK for Keratoconus

Question: I'm 21 years old and I've been wearing gas permeable lenses for a few years now. I have Keratoconus and have been told that I pretty much don't have a chance at having LASIK Surgery. I was also told that I could not wear glasses and see correctly out of them, but when I bought some glasses, I actually wear them every day now and don't have a problem with them. I drive with them and everything. I'd really like to know if LASIK is an option for me because it would really help me out a lot in multiple aspects of life.


Answer: While their has been some controversy regarding the appropriateness of performing LASIK for Keratoconus patients outside of the U.S., Laser Vision Correction for patients with Corneal Diseases such as Keratoconus is not generally indicated for a number of reasons at this time. If you do in fact have Keratoconus it means the Cornea is structurally weakened and is thinning and "bulging" with resulting instability in the shape of the Cornea. Laser Eye Surgery for vision correction is a "tissue removal" procedure in which the Cornea is actually thinned further-this would no doubt accelerate the progression of the Keratoconus. In addition, the integrity of the collagen in the Cornea of patients with Keratoconus is compromised and it reacts very unpredictably to the application of laser energy in the way it heals. At the moment this is not a good choice for you. However, there are treatments for Keratoconus in clinical trials that may allow the application of Laser Vision Correction for Keratoconus in the future.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.