Correction of Hyperopia and Astigmatism with At Lisa
Posted , 6 users are following.
Hi everyone,
I finally decided to make a surgery on my eyes to permanently eliminate my addiction to glasses. I am 49 years old and have a strong hypertrophy +6 combined with an astigmatism of +1.5 RE 1.75 LE.In the beginning I wanted to implant the EDOF AT LARA but after reading experiences in this forum and and listening to the doctor who will operate me, I convinced myself (so to speak) to use the AT LISA but I do not hide my concern for the post intervention.
The fact is that I have no cataract and with (progressive) glasses I see perfectly.
It is only a desire to take off my glasses after 49 years.
Your opinion would help me ... Based on your experience and the results obtained after the surgery (for those people who obviously have performed the same lens implant) do you think I am going to commit nonsense to operate?
thanks all in advance
Mirko
0 likes, 20 replies
janus381 Mirko00758
Posted
I had cataracts and and extremely pleased with results with tri-focals (I got the Alcon PanOptix). Before surgery, I was similar to you in that I needed progressive prescription lens to see anything, thought I'm not myopic as you are. So I was happy to get the chance to be free from glasses, and understood that I might have halos and starbursts or other issues (in my case pretty minor).
However, if you see fine with glasses, and this just comes from desire to do away from glasses, I personally would not do it. it is not so much the risk of halos and starbursts, which for most people is not significant or will go away as the brain learns to filter out the noise, but it's the risk of worse outcomes. If you have cataracts, you have no choice, you must do surgery and the risk is small.
I responded to a similar question posted by Delia (IOL Procedure), so repeating some of my prior response here:
If you do see reasonable well with glasses, then this is purely elective. The worst case scenario if you don't do the procedure is that you will continue to wear glasses until you eventually develop cataracts, and then you will likely have better IOL options to choose from (as IOL improve every few years). If you do RLE procedure, there is very good chance you will be happy with the results, but the worst case scenario is impaired vision for the rest of you life (then you would regret having decided to do a purely elective procedure).
If particular while the risk of a very bad result is small, it is not insignificant, and it is important to note that the risk is much higher for RLE patients than cataract surgery patients.RLE patients are much more likely to eventually have retinal detachment than standard cataract surgery patients (due to most RLE patients being highly myopic and being younger - read in one article risk of eventual retinal detachment is 25 times higher). And RLE closes the door to better IOL designs that will come.
Many eye surgeons (including my surgeon) who are not interest in maximizing their income are also very wary of RLE. If vision is extremely bad, and person is getting close to age where cataracts are likely, then maybe. But if it just because person is tired of having to use glasses/contacts, or doesn't like progressive prescription glasses -- then I don't think it's worth the risk.
Search for article:
"Refractive lens exchange: is it worth the risk?"
Mirko00758 janus381
Posted
Junus,
Thank you so much for your long explanation.
Definitely you are right, in my case, because I've not a cataract and have a good vision with my progressive glasses should be more appropriate to wait until the onset of a cataract, furthermore we should talk about RLE for my case (sorry if maybe I'm not 100% in the right thread).
But as I said, my dream is to have a life without glasses, and I though that actually we can consider this like a really low issue incident surgery at the moment.
In my case that I'm not myopic but hyperopic (+8, 49 years hold man with presbyopia) I should be a good candidate; I hope now that I'm not in wrong.
Let me say that I want to be pretty optimistic based also on the collected informations, but what it most worried me are the sides effect with the trifocal. I heard that the pilot normally use to implant the monofocal, of course I'm not a pilot but I take this consideration (if this is confirmed) like a good one; If they can pilot a plane with a monofocal, maneuvering with all that commands, meanings that monofocal are a good solution... I could accept to use a PC/reading glasses honestly, I will be like a normal man at my edge...
That said I know perfectly that nobody can fix my concerns so is just something that I need to agree with my self.
At the moment I'm waiting that the Dr call me for day of surgery and we have agree for the At Lisa, but he told me that because there always an 1% of case were during the surgery this lens can not be installed, he will have always a monofocal available there just in case.
Thanks
janus381 Mirko00758
Posted
Mirko, I got confused. If you are a hyperopic , not myopic, then I believe the risk of retinal detachment is not elevated, so RLE (or clear lens exchange -- seems like there are different names for cataract surgery before you have cataracts), could be a option.
Still personally, I would not do it if I were in your shoes.
You say you see perfectly with prescription progressive glasses. If you see perfectly fine, I would not suggest taking unnecessary risk with RLE.
While most people are very happy, a good number experience halos, glare, starburst that may go away over time (but may not).
How's your distance vision? If it is very good, then replacing your natural lens now may result in not as good distance vision.
Again, I got tri-focal IOL and I am very happy with the results. But I personally would not elect to exchange my natural lens if I could see perfectly fine with glasses.Worst case scenario is much worse for choosing to go ahead than if you just wait. All for desire to do away with glasses (and if you still need reading glasses after, is it really worth it?).
Mirko00758 janus381
Posted
Janus,
Yes, my vision is very good with my progressive glasses after accepting the compromise with this glasses of course (fuzzy sides vision, neck pain etc.).
I forgot also to mention that I have a amblyopia, my right is real dominant, but I don't think that this change my clinical situation in regards of a possible RLE.
You asked me if I would accept the situation where I will still need to wear reading glasses.
Well let me say that if this can happen, it could be acceptable for me but only if the rest of sight vision works good.
I know, sometimes is not easy to fully understand how big is the desire to have a life without glasses for a man like me which has always depended on their use.
That said I will never say that you are in wrong, I think you are in right!!!
I shouldn't accept the risk of a worst post surgery outcome even if this possibility is rare.
But this concept should be extended to all refractive surgeons in general such as lasers (lasik / PRK), these too are not foolproof and in many cases create greater problems for a future appearance of cataract for the calculation of the power of the lens when you will have to replace it.
This is at least what I think I understand, then. I'm not a doctor and maybe I'm in wrong.
About the glare and flare....
Curious thing: yesterday night I realized that I have actually flares and some stars blast with my glasses on, and let me say that if I concentrated on them, I can not say that they were negligible, my brain simply doesn't consider them ... This will probably be because I have always had them not for a year or two, but all my life.
This helped me to better understand the concept of brain adaptation.