Anyone had a secondary IOL?

Posted , 5 users are following.

I had cataract surgery a few years ago and got a spherical lens, but I have extreme astigmatism and should have had a toric lens. I'd like to correct this now with a secondary lens, but both the surgeon and the optician have advised against it on the grounds that any eye surgery is not entirely risk free, and my vision will be worse after the surgery than it is now. The optician clarified that, of all the patients they've seen after a secondary IOL, none have been glasses-free, and they've found it difficult with glasses to bring the visual acuity back to the level that it was. I don't really understand this as I've recently had a toric lens in the other eye, which has massively reduced my astigmatism, and the little astigmatism that remains was easily corrected with glasses to a good level of acuity. What's so bad about secondary lenses?

0 likes, 6 replies

6 Replies

  • Posted

    I don't know much about a secondary, or I believe what is called a "piggy back" lens, other than they are a possibility for correction without removing the IOL.

    .

    Have you considered Lasik? I looked at it, and have seen two clinics for a consult. I wanted my Sphere made more myopic by about 0.5 D, and at the same time have my astigmatism reduced. They have basically told me that they can fix the astigmatism but not make the increase in myopia. Apparently reducing it is easy, but increasing it is not. If you only want to reduce astigmatism it may be an option for you if your sphere is ok, or you want to reduce the myopia.

    • Posted

      Thanks for the reply. Interesting to know that Lasik can't increase myopia, I wasn't aware of that. In addition to the astigmatism, I also have a bit of hyperopia (2.5 D) so I guess they couldn't reduce that. In any case, successive opticians have all put me off Lasik. They get offered good deals to have the procedure done themselves, presumably on the basis that they will then recommend it to their patients, and remarkably few of them take it up. They get to see all the cases where it causes side effects like severe dry eyes and it puts them off.

    • Posted

      I was misled by my surgeon on what they could do with Lasik. I didn't get the true picture until I actually had consults with Lasik specialists. The is a slight variation to Lasik called PRK. It is very similar but they peel the outer layer of the cornea instead of cutting a flap and pulling the flap back to do the laser cuts to corrections. It may be less susceptible to dry eye, but not sure.

    • Posted

      The surgeon who did my YAG also does LASIK/PRK/etc.

      He disclosed to me that:

      1. The risk of missing the target of Astigmatism reduction is possible.
      2. I will most likely have dry eye after the treatment, but the magnitude of dry eye MAY be reduced after a year or two.

      I'm 65 now, five years ago I developed significant dry eyes, but only while i'm asleep for some mysterious reason (my lids are fully closed during sleep). So, I'm not willing to risk exacerbating the already unpleasant problem with LASIK/PRK, especially since it may not even be very effective...

  • Edited

    If having the high probability of wearing glasses anyway why not correct the astigmatism with a contact lens or glasses?

  • Posted

    How about a scleral contact lens for the one eye with the spherical IOL? A scleral contact is very comfortable, and it automatically corrects corneal astigmatism without being toric. The lens arches over the cornea, rather than touching it, and the resulting enclosed space is filled with liquid, making the perfect surface of the contact lens the refractive surface and rendering the imperfections of the cornea's surface irrelevant to vision. The downsides are it takes a lot of practice to get good at putting them in and taking them out and they are expensive. But if you can get a keratoconus diagnosis, then they are covered by medicare and other insurance.

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