IOL Choice for Amblyopia (lazy eye) - Need Opinions
Posted , 7 users are following.
My wife went in for her cataract pre-op consultation today. I did not go with her due to COVID restrictions. I thought it would be a simple consult and that I could not add much. I had her primed to ask if the Alcon Clareon lens was an option instead of the Alcon AcrySof IQ. But, wow, did that open a can of worms, and I am interested in opinions of what to do next.
.
Here is the situation. She has one eye suffering from amblyopia for her lifetime. When she gets eyeglasses it is so bad that they don't even prescribe any correction. She just gets a plano lens and essentially can't see anything but a blur out of it. The other eye up until the cataract has been good. She gets a very mild prescription and most of the time she does not wear prescription glasses at all.
.
Now for the complications. Her eye was measured and she has mild astigmatism in the good eye at 0.50-1.25 D, and a cataract of course. The amblyopia eye has severe astigmatism at 7.3 D, and the cataract is worse in that eye. The surgeon recommended doing the amblyopia eye first as he likes to do the worst eye first and says he learns things that he can apply to the better eye which he leaves to be done second. He feels there is benefit in doing this eye as it will get rid of the cataract and let more light in and possibly achieve some vision...
.
When she asks about the Clareon option he says he likes the lens and recommends it. It costs $300 per eye more than a basic AcrySof IQ, but is done in his clinic and is available much sooner (6 weeks)... It seems his recommended course of action is to do both eyes with the Clareon lens. We will have to confirm it, but I don't believe the Clareon is available as a toric yet. So this will leave here with mild astigmatism in her good eye, and severe astigmatism in her amblyopia eye. I guess the assumption is that eyeglasses would be used to make the final correction if needed.
.
But, then I read the package of information she was given, and it does not talk about the Clareon option at all but says she qualifies to use a toric lens at and extra cost of $1050 per eye. My wife does not recall him recommending a toric though.
.
So what do you think? The course seems to have been set to do both eyes using the Clareon non toric lens, with the amblyopia eye first. The other option would be to do both eyes with AcrySof IQ Toric lens and possibly wait 6 months or more for the surgery. Or, reverse the order from what he prefers, and ask for the Clareon in the better eye, and wait to do the second eye with a AcrySof Toric? He apparently did mention that he likes to use the same model of lens in both eyes. I think that is bogus as the lenses are so similar. And underlying all of this is that I am skeptical that she is going to see anything out of the amblyopia eye regardless of what lens is put in it.
.
Thoughts???
0 likes, 18 replies
Elishac123 RonAKA
Posted
Hi, I'm late to the party and I've just read about yours & your wife's experience and I'm very interested to see how she got on.
I'm 27 and about 8 years ago or so I had cataract surgery on both eyes due to apprently being born with them and I also have amblyopia in the left eye.
I live in the UK and I bad my operation done via the NHS. I was never given the option to go private and it wasn't until a few years later when I realised I could have potentially gone for a better lense , by that time it was to late, something to with not being able to take the lense out the sac or something.
Anyway, prior to having the operation I've always meant to have worn glasses, but I never did, due to my vision being fine without it, however since the operation I've been restricted to having to use varifocals (progressive lenses) for everything. and my vision without glasses is pretty bad, due to having to have a monofocal lense I now cannot focus and they're fixed at one distance, so I cant read without glasses etc.
Anyway, I've never managed to find anyone else that was in the same situation as me, I've always felt like I was one of the only people in the world with eyes like mine so I just found your story quite interesting and I was just very curious to hear about your wife's journey.
I'm lucky in the sense that with glasses my vision is pretty great, I've just had to adapt to being restricted to one distance and using my progressive lenses to see others / relying on glasses all the time etc.
Thanks
Elisha
Elishac123
Posted
Also you mentioned your wife's depth perception is okay, mine is as well which is strange, as I know this requires both eyes, so I guess even with amblypoia the eyes still do something!
RonAKA Elishac123
Posted
Well my wife has gone to the surgeon about 4 weeks after the surgery on the lazy eye. We will have to acknowledge it as a failure to restore good vision. The surgeon says sometimes the lens replacement works, and other times it does not. He suspect the damage was done during her birth and the nerves from the eye never developed. Perhaps in case where there is some vision as you describe the prospects are better. Her other eye is great though. She got it looked at 3 weeks post surgery and it is 20/20 for distance. She has lost some of her near vision and now wears +2.0 Readers for close work. She will not go back again until about 6 weeks. She still has not decided if she will get progressives or not. She prefers to not wear glasses so I suspect she will just stay with readers as she needs them.