I am 55yo and yet, have not developed cataract as of now. Nevertheless, I am contemplating IOL surgery to correct my myopia. I am not expecting total independence from glasses and I have done lot of research online on the positives and negatives sides, etc.. I do have some questions regarding different IOLs which I will ask later in another thread. My first question however is regarding the safety level of IOL surgery. I understand it is a relatively safe procedure but there is always chance of complications. I am wondering in comparison to laser eye surgeries, can one assume IOL surgery is equally safe? Or, laser eye surgery is still a better (=safer) choice? Even though the surgery itself seems safe, I have just learned about the PCO complication which is very likely to happen some time not in the near future and requires a YAG treatment which adds its own risks. I had assumed an implanted IOL is good to go for pretty much the rest of life but that might not be the case. So I am wondering what your opinion would be on the matter. Thanks
Don't do it if your corrected vision is acceptable right now.
- Even at 55, your natural lens accommodates, admitting the best possible light from targets at a variety of distances. Most of us lose some near vision accommodation after age 45 or so but it still works for intermediate targets. IOLs can't match this and IOL vision will suffer in low light situations. CrystaLens claims to replicate a modest level of accommodation but most surgeons today think there are better options with the non-accommodating lenses.
- Safety is pretty good but even if there is just a 3% chance of a bad outcome that would reduce your vision to substantially worse than it is now, is it worth it?
- Lenses, materials, and surgical equipment are much better than 10 years ago. They'll be even better and safer when your best correctable vision becomes unacceptable.
Right now, I use progressive glasses at home. It is good for intermediate distance but not for near distance. Its reading power is +2.25 and I may need to change it some time soon. I don't like using it outside home as the ground is blurry with it. Instead I use my normal non-progressive glasses when I am outside. My non-progressive glasses give me a functional but not perfect vision at intermediate distance! If I need to read something at near distance, I just remove my glasses and bring my head close to the target at about 25cm.
You lose the "gift of myopia" (up close detailed vision) with IOLs. I just replaced mine because of cataracts and am just realizing how much I relied on just taking glasses off to read pill bottles, ingredients lists, and about anything else in small print.
When I wore -5D/-6D progressives, I found that my vision was much better when I used premium lens manufacturers rather than cheaper. I liked Hoya but imagine Zeiss would also be excellent for progressives. Progressives must be harder to make and fit high myopes. I spent 4 years after needing progressives before I found using better lenses makes all the difference.
My simple advice is, never do surgery that is not medically necessary.
Do not do it. Do not even think about doing it. Your natural lens has a lot of advantages that you do not want to give up until you have to. You will totally lose your accommodation ability, which is the ability to change the shape of the lens for different distances. The EDOF and MF technology in IOLs is not even close to what the natural lens can do. . Lasik is a little less invasive and risky, but the problem is that it permanently changes the shape of the cornea, and not in totally good ways. It can induce optical issues that an IOL later in life cannot correct. It also makes it difficult to measure the eye for an IOL. Implanting an IOL is much more invasive and permanent compared to wearing contacts. There are complications if the surgeon makes a mistake and the lens has to be explanted. . In short do not even consider an IOL until you have a cataract to deal with, and it will happen. . I think it should be illegal for surgeons to offer a clear lens exchange to an IOL simply for the chance of going without glasses. . The safety level of an IOL implant is not the issue you should be concerned with. It is the loss of your natural lens that you should be worried about. They cannot put it back in your eye as it gets destroyed in the implant process.
Thanks for the advise. In Canada, there doesn't seem to be any law against IOL surgery for myopia correction. I did have an appointment with Lasik MD to examine my eyes. I am sure they would have told me if it was illegal. I do have appointments with other clinics next week for consultation as well. Consultations are free so it doesn't harm.
Raminolta, You got excellent advice. Don't do cataract surgery unless you need it, and even then you can wait a few years, although the longer you wait the denser your cataract becomes. But by the time you develop cataracts, IOLs will be even better than they are now, and the surgical procedure itself may even be better. I wouldn't do LASIK either for the reasons Ron mentioned, and also because it can, in some patients, cause painful dry eye disease.
What they said. Don't do either.
raminolta, You've made statements that demonstrate that you've been researching, and that's very good! As for the LASER, in cataract surgery it is used to assist, making incisions more precise and facilitating the fragmentation of the eye's lens for phacoemulsification, among other refinements. But I don't remember reading that the use of LASER increases safety. Many surgeons, not being necessary, prefer not to use it. You mentioned that you just found out about PCO and YAG, and I feel like you got some fear!? I believe everyone on this forum is going to tell you not to trade your healthy natural lenses for artificial lenses (IOLs). I suggest that instead of researching the "advantages" of an IOL, pretend you DON'T want one, and research all the problems and compromises that come or might come with them! Vision limitations regarding distance, loss of contrast, loss of vision in low light, dysphotopsias, floaters, PCO, retinal detachment, epiretinal membranes, etc. Perhaps, as greg59 said, premium quality progressive lenses will give you the best vision you could ever have!
" I have done lot of research online on the positives and negatives sides"
One Question, "Positives from Whom????" The manufactures?
My Advice, from someone that has had both my natural lens replaced due to cataracts, "Don't!!!!!!!!!"
If you want to get rid of your glasses I would suggest investigating mini-monovision with contacts. Mini-monovision is one of the better ways to get a full range of vision with IOLs that is quite side effect free. You however can do the same thing with contacts. The trick is to fully correct your dominant eye for distance, and then under correct your non dominant eye by leaving it at -1.5 D. Especially with some remaining accommodation ability in your natural lens, you should have a good full range of vision from 12" out to infinity. Silicone hydrogel contacts have gotten pretty good. To simulate monovision before my cataract surgery I used Costco Kirkland ones that worked quite well for me. They are relatively easy to put in and take out, and are quite affordable. And, this will give you a good preview for what you might want to consider when it comes time to deal with cataracts.
please do not do this to correct myopia. There are worse things than glasses. Once your natural lens is removed it is irreversible. This is for those with cataracts. Not many here would recommend this surgery for vision correction. Maybe scroll through some of the threads.
so agree this should not be permissible outside of cataract surgery. And many greedy surgeons will line their pockets with this unnecessary medical procedure calling it something else. Took me a long while to convince brother in law that he had cataract surgery! Had to show him black and white. One of the selling features his surgeon mentioned was with this surgery you won't ever get cataracts!!!
Didnt say there was no law against it. Just our thoughts it should be illegal. Once upon a time you could mutilate your dog's tail or ears to make it look a certain way - wasn't illegal till a few year's ago.
if your goal is to off the glasses to read - get ready for a shock. Distance has a far better chance of hitting the mark. But most of us need readers yo read and those of us like myself (cataracts st 53) with an EDOF lens have a wonderful night show once the sun goes down. Massive 10 concentric circles around lights (traffic lights for example). One gets used to them - in familiar places but I would bot want yo drive in a bog city or crowded highwsy at night. I knew this going into surgery - had to chose s compromise. But had no choice best corrected vision with cataracts was 20/60 in RE and 20/50 in LE. Could not read even big E with glasses on.
Please think through this carefully. Your surgeon gains $ by doing this. Everyone eventually gets cataracts. In Canada surgery will be free.
Oh and one more thing to be aware of cataract surgery itself can bring on additional vision issues. Detached retina - myself I developed Epiretinal Membrane - and % higher for younger patients to have these issues. Please please think twice.
Thanks for the suggestion. I tried contact lenses a couple of years ago but they never worked for me. I remember the first time I tried putting them in my eyes (with the technician's assistance). It seemed so hard to do and took almost an hour. Eventually, I managed to put them in my eyes. However, my eyes just didn't like them. It never felt comfortable with them with lots of strain and discomfort in my eyes. After a few months, I gave up and returned to my glasses.
There are different types of contacts. I also gave up on contacts at one point due to difficulty in putting them into my eye. There a two common types of contacts on the market. One type is made from a hydrogel material. They are cheaper and an older technology. Of that type at one point I was fitted with the J&J Acuvue Moist contacts. They totally turned me off on contacts. They were so flexible and floppy they were impossible for me to handle. And that was after wearing soft contacts for many years starting in about 1975. And on top of being difficult to handle, contrary to their "Moist" name, I found they dried out during the day. That made them difficult to get through a day with them. . Then I found out about a newer material called silicone hydrogel. They are stiffer and much easier to handle, and surprisingly they are more comfortable and I could essentially wear them for a whole day. After testing a number of lenses at Costco I settled on three that I found very good: . 1. CooperVision My Day disposable 2. Alcon Total 1 3. J&J Acuvue Oasys
Costco in Canada sells the CooperVision My Day under the Kirkland brand name, and that is what I ended up selecting. They were night and day different from the Acuvue Moist hydrogel contacts. I would encourage you to give one of those three lenses a try. Costco, if you belong, is a good place to test drive them, as they are generous with free samples.
Thanks for the contact lens suggestion. I will certainly give the new type a try soon. Regarding the IOL replacement, I initially thought they were a reasonable alternative to laser eye surgery. I know some people have done it merely for less dependency on glasses. Someone on Youtube speaks of his experience with trifocal lenses. He opted for them simply to get rid of reading glasses (that is only for presbyopia correction). Overall, he seems content of the result. That said I am now hesitant and want to postpone it as the risk seems higher than my initial estimation and the reward may not be that great. I have also noticed there are new types of upvoming accommodating IOLs that may become available to the public within a few years. Some of them are already in the testing/trial stage (Juvene IOL) . These exciting new lenses seem to address some shortcomings of the currently technology: they providing accommodation without compromising on the optical performance. More importantly, they also seem to reduce the likelihood of PCO happening because they fill and stretch the capsular bag like it was before IOL replacement. So I think I am going to wait a bit more. Though on the other hand, I sometimes think waiting all these years for the technology to advance enough to give a reliable good solution may not make sense. I certainly want to enjoy the benefits before I grow too old to even bother.
I had an appointment with an ophthalmologist at Lasik MD and she stated I do have cataract though it's still at an early stage so I can still wait before doing an IOL surgery. She wasn't in favor of using monofocal IOl and believed if I don't want multifocal or EDOF IOLs, it would be better to wait since some new exciting technology is on the horizon that is, the upcoming accommodating IOLs. I had read about them too and like very much the idea of modular accommodating IOls particularly because fill the capsular bag so there is less risk of PCO happening. She said they would probably be in the market within the next 1-2 years though I am not that optimist. Even the Juvene IOL which is at the human trial stage right now (in the US) might still take a few years before being approved (in Canada). I am wondering if anyone knows about the new bionic lenses that are being developed in Canada? I recently read that they are also now at the human trial stage. The available information online is scarce.
What city in Canada are you in? The reason I ask is that after my second IOL surgery I ended up with astigmatism and some associated vision issues with it. My surgeon suggested that I could get a Lasik correction and recommended some Lasik clinics including Lasik MD (Edmonton Centre location). I saw them first and was told they could not make the corrections I wanted. Aside from that I was extremely unimpressed with their clinic. They seemed to have very inexperienced staff. With cataract surgery on both eyes and both eyes being measured twice, I had a fair bit of experience with what the measurements are like. They kept taking the measurements over and over again. I lost count how many times. In any case, the short story is that I would not touch that clinic with a 10 foot pole. . I then went to a second clinic called Eye Q Premium Laser. It was a night and day difference. They quickly and efficiently measured my eyes, and then I saw Dr. Leong-Sit. He was very thorough and explained the situation to me in detail. He even asked for some more measurements to be taken and then met with me again. He said that I had a thin cornea and that was the cause of my irregular astigmatism, and that I probably had keratoconus, and would not be suitable for Lasik. While I got turned down for Lasik, he is going to see me again to determine if my keratoconus is stable or not. This clinic does cataract surgery, and if I had a chance to do it all over again, I would go to this clinic. . In any case the advice to wait, with a possibility that better IOLs will come along, is good advice. Accommodating lenses have been "coming" for a long time though, so I would be very surprised if they are only 2-3 years away.