Lasik enhancement evaluation after cataract surgery

Left eye was done one week after right eye in December. So it’s been 9 months. Vision does not improve with use of eye drops for dry eye. 

The whole point of multifocal lenses was not to wear glasses. The prescription for glasses is a temporary gauge to see if addituonal lasik will be an asset. 

Honestly, I’m considering having the multifocal removed and going to a clear lens set for distance. This is just beyond my acceptance range at this time. I feel completely mislead by surgeon.  Also I still have the rim effect in right eye and a “wrinkle” in the posterior capsule “maybe” causing some issues. 

So sorry about your ongoing vision issues.   Yes surgeons often mislead as there is much profit in this for them.  I wish more were upfront about expectations.

Although for many multifocal and EDOF lenses make them virtually glasses free - it certainly never can be guaranteed.   There are factors beyond the surgeon’s control - like a wrinkle in the capsule but also the IOLs come in increments of 0.50 diopters (not 0.25 like glasses or contact lenses).  The power calculation can be off too if you’ve had prior lasik or PRK procedures.  Then to add to those the healing process can leave you .25 diopter near or farsighted depending on where that IOL settles.  Maybe a day will come when the power can be tweaked once implanted (other than a lasik enhancement) but until the lenses and procedures are better NO SURGEON should guarantee a specific result.

I should mention that many with monofocals if a mini monovision approach is used can experience life without use of glasses all the time.  Many just use for reading prolonged periods or tiny print or if they are set for intermediate and near wear glasses just to drive.

Your IOLs can be exchanged if you haven’t had a YAG but the surgery carries more risk.  The surgeon should have more skill.  My own told me at consult he doesn’t do explants.  So if considering look into a surgeon that has vast experience with that procedure.

I do hope you get some clarity and peace as to what to do next.

All the best Julielyn 

Yes Sue an I’m aware of all these things now!! Monovision was not an option for me as you have read in previous posts. 

Thanks for you reaponse as I’m sure it will help others 

I can relate Julielyn - I was never 100% sure monovision (even if mini) would work for me.  If my cataracts weren’t already advanced I would have tried it out with contact lenses.  I suffer from migraines, tinnitus (bouts of vertigo with that) so didn’t want to add vision imbalance to that mix.

I feel for your situation and sincerely hope something can be worked out.  

Also I recall that Andi who has posted on the forums many times saying she doesn’t need glasses at all with her monofocal IOLs both set for distance.  Needs glasses just for tiny print.  She has regular (not toric) IOLs.  Perhaps if you are considering exchanging yours you could reach out to Andi to ask what brand.  Just a suggestion.

Left eye being your dominant eye, I can see why. <i>"cataract surgeon suggested months ago, but has now recanted that offer.  He believes lasik or PRK would be a better solution."</i>

Given what your eyes have gone through (traumas of implant and explant, possible PCO, dry eyes), trans-PRK claims no corneal flap complications.  There is a truck load of writers tauting the virtue of a Corneal Wavefront (ie: topography-guided) SmartSurfACE transPRK on the Schwind Amaris 1050rs laser.

FDA has not approved this machine yet, but is available in Montreal, Toronto, Winnipeg, Calgary, Edmonton and Vancouver. It claims that the patient's recovery time is substantially shorter. The quoted price exclusive of any follow-up care is in the ballpark of C$6000+ depending on the locations.

Germany's AugenKlinik uses the same SmartSurfACE / Schwind Amaris 1050rs laser, and is charging €2.500 for both eyes, including all pre- and post-op exams and medications.

Here’s my thoughts about left eye jantje. I’m 20/40. Reading is nearly impossible without cheaters. Very fuzzy with ghosting also. If lasik is done to enhance the distance, it will do nothing for the near vision, then I’m stuck/forced to wear cheaters( reading glasses). My goal is to be glasses free, is there still a possibility for that due to miscalculations in iol implant?  Second opinion cataract surgeon thought so in March. 

So I’m patiently waiting for Zenni Optical to send my new RX glasses ( $25) to see if lasik would improve my reading enough to be satisfied with lasik outcome.  If not, I will be insisting on iol exchange, since surgeon once again didn’t get the power correct. It seems that if we would have waited inbetween surgeries the outcome would have been much closer. It appears that we should have gone up 2.0 in lens size instead of 1.0, as dr said just wear a +1 reader...that never worked for me and I did tell dr that info .  Even the lasik evaluation dr said same thing. Wear a +1 reader, and I said it doe st give me clear results I’m closer to a 1.75 

I honestly don’t know the calculations between glasses and iol lenses but I recall the dr saying something of for each 1. The lens is 1.33 but of course I don’t know. 

Thanks 

Whatever route you take, I wish you all the best.  Personally a lens exchange is outside my comfort zone, and our eye-surgeon will not do it for cosmetic or economic reasons. We are taking Lutein, vitC, vitE, zinc supplements still and foods best for eyes.

People having problems with their premium lenses rarely return with positive updates;  julian1969 and Nizza594 had shared that for some it may take 3 months to a year before both eyes to adjust to near and distant vision.  If only more forum members will return with their feedback, they can help others.  One guy bitterly complained about his blurry vision 6 months after Lasik surgery, and disappeared online for over a year. I messaged him, and he replied; he had 20/20 vision exactly one year later and is 20/17 now. jeez

I certainly wish that were the case for me. I’ve been consistent 20/40 since coming off Rx drops.  My original surgeon said from day one that an exchange would be done if needed. He couldn’t calculate the power correctly, and after today, speaking with this surgeon, I now know why the need for reading glasses. The range for the restor 2.5 is not great. It will not cover reading distances, but intermediate should be good. Well, I haven’t had either one. So honestly, now that I’m home from the mainland (2.5hr drive) and lots of time to recall what was said.  I think I will just have these multifocal lenses removed. Since the one with the arm sticking out ( I have a great visual here) needs to be exchanged anyway. I don’t recall anyone on here with one multifocal and one clear lense. That would be really weird vision I would think. Anyway, I think I finally got my answers as to what to do. Forget the multifocals and be forced to wear readers for eternity. I had a good run between lasik in 2001 and needing readers @ 2013. 12 years of being glasses or contact free was worth the lasik then. 

Julielyn lots of people have a mix of IOLs and do well with that setup.  At201 has a monofocal in one eye that was implanted many years ago and a Symfony Lens that he has had for 2 years.  If one of your eyes is gone witb the restor 2.5 lens personally I wouldn’t explant it and exchange for a clear lens.  

This must be so incredibly frustrating.  And sounds as though if you hadn’t told this doc to wait till after eye dialation he would have done a YAG

How on earth did the arm wind up outside the bag?  Was it incorrectly inserted in first place or moved afterwards.

Whatever you do seek out lots of doctors before selecting one for a lens exchange as it is much more involved and requires a surgeon with more skill than original IOL implant.

Good luck to you Julielyn 

Sue.an this will be my 3rd exchange if we need to do it. So yes, I have had 2 “experts” give me their opinions. One before the exchange and now another after the exchange. I have chosen these two second opinion drs because of their experience in exchanges, one from sight trust in sawgrass(ft lauderdale) and the other in Miami. I will not return to my original surgeon other than to tell him what I now have to have done to correct the problems he may have created(or my lawyer may contact him). The arm outside of the bag can not be determined if it happened during surgery or after. Like the dr said. It happens. Considering it wasn’t seen by my original dr or the lasik evaluation dr two weeks ago definitely reassured me that having a dialation today was the wisest choice before proceeding into yag as I also wanted it confirmed that the lenses I had installed where the correct lenses...that was the point of the visit. Yag would not have been performed without dialation either way. I was explaining how the visit went time wise, so if I confused you