Amblyopia and Cataract Surgery
Posted , 3 users are following.
Hello all,
Since my situation is somewhat unique I thought I would share my experience in the hope that it may provide some help or information for someone in a similar situation.
i have been a lifelong myope with a left eye prescription of around -3.5. My right eye which is the lazy eye is actually hyperoptic with an astigmatism. My two eyes do not work together, when i close my "good" i can make out shapes, see people, but cannot read with it. Essentially I have lived with one eye my whole life.
About a year ago i started to develop a cataract in my left eye, given my situation my optometrist was very reticent to refer me for surgery at that point however this cataract was very fast acting and within a year I was at -7 and to be blunt was getting really scared both with how fast this was progressing and with the fact that if something went wrong with the surgery I'd be in real trouble vision wise. As "luck" would have it my right eye has only a very early cataract.
In any case I felt I couldn't put this off any longer,I did extensive research and I didn't want to take any chances with anything other than a monofocal, I've been wearing glasses my whole life and my goal was to have the best possible vision with the least amount of potential issues as I'm only really dealing with one eye. . My ophthalmologist
didn't suggest doing surgery on my lazy eye at this time.
I actually ended up going with the eyehance set for -2. My feeling was I've always read close up without glasses that's what I'm used to, so why would I want to change that now. I ended up at -1.5 which I am very happy with, I only wear glasses for driving and tv (sometimes). I was extremely nervous before the surgery but everything went well including post-op.
I am posting in the hope that this may help someone in a similar situation.
0 likes, 4 replies
RonAKA s87582
Posted
My wife went through a similar experience a couple of years ago. We decided the same about not taking a chance on a multifocal lens, and decided with only one functional eye, that a monofocal was the way to go. The surgeon claimed there was a slight chance of regaining some sight if they were to do the amblyopic eye. He suggested she do it first as he could learn something about doing the second eye. The measurements indicated she needed a very high degree of myopia correction and even higher astigmatism correction. It was so high that the highest readily available toric lens (6.0 D Cylinder) was not high enough. So, she went ahead with the correct sphere and the 6D toric. The surgery went well, but the short story was that it did not work. She said everything was brighter and she could see shapes a little better, but there was no chance of reading even the "E" on the eye chart. It did not improve over time. During surgery the surgeon saw what he described as scar from a tear in the cornea. He said that it is possible the eye was damaged with a forceps delivery, and was never discovered until it was too late, so the optic nerve never developed.
.
She went ahead with the second good eye with another toric with what was the lowest available power this time - a AcrySof IQ Toric with a 1.0 Cylinder power. She got excellent 20/20 distance vision and now uses reading glasses to read.
.
The problem she has had over the years is that she could never see well enough to get a power measure of her refraction. We had no idea how bad her refraction was until the IOLMaster measurements were made for surgery. If we had it to do all over again I think another option would have been to use those measurments to replicate the vision correction it would generate by using a phoropter to provide that correction. And, if the phoropter did not correct vision enough to read some of the letters, it probably would have made sense not to spend the money on a toric lens and just go with a plano monofocal. You may want to think your way through that when it comes time to deal with the second eye.
s87582 RonAKA
Posted
Thanks for your reply, I guess what my question is, is at what stage should surgery be done on a amblyopic eye that has a cataract? It's really only a "background" eye for me and my understanding is that it can't really improve the vision other than making the limited sight I have it that eye clearer. I guess at some point it would have to be done to keep the sight I do have in that eye.
RonAKA s87582
Posted
I think if there is no hope of vision then removing the cataract clouded lens may not be essential. However, at some point the cataract lens may become visible to others if that is a concern to you.
.
I think however, if there is some hope of regaining vision I would get the eye measured if it has not already been measured and try the trick that I suggested above. Have the optometrist simulate the correction that would be provided by an IOL correction to see if that improves vision. If it does not improve the vision then it may be just a matter of the clear lens vs a cloudy lens.
s87582 RonAKA
Posted
Your suggestions are appreciated, thanks again.