PCOs ??
Posted , 9 users are following.
So it's about a month before my first surgery now. I still haven't fully decided on lenses yet. I'm pretty sure they'll be either Vivity or Eyhance, or one of each. Definitely monovision, which I've had with contacts for 19 years.
I was talking with my surgical coordinator and brought up PCOs because I read up to 50% of patients develop them in the first 5 years. I know they're considered easily correctable, but there's still risk involved.
So she said to me 'everyone gets them'. I said 'well not EVERYONE' and she said in the 20 years she's done this, it's 100%. 'It might be 5 weeks or 5 years, but everyone gets them, doesn't matter which lenses they have.'
How can it be 100% get PCOs?? I don't want them. Please tell me your experiences.
0 likes, 12 replies
adam06539 MsJ101
Edited
If you "don’t want them", don’t go with any surgery. I'm sorry, but that's how it is. You can end up with much much worse complications than PCO. If something is correctable (PCO is), it's not a true complication. I think you need a little bit more imagination what can go wrong (worse) with a surgery.
MsJ101 adam06539
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Not the point, not helpful. No reason for such attitude. Why even take the time to respond if you're just going to be rude. That's what twitter is for.
ad12345 MsJ101
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I didn't mean to be rude, sorry for that. I just tried to explain you that it's not any real complication you should be afraid of as there are tons of other possible risks. You just cannot predict it. If you are older, it's very likely you won't get it. If you're young, you will get it. Hope this helps.
neverquit MsJ101
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My wife has bilateral multifocal lenses since 14 years, and not the slightest sign of PCO. But it´s more likely to get it eventually, than not getting it, i would say. But it´s a quite minor, solvable problem.
Binki MsJ101
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I had PCO 15 months after first eye cataract procedure. Zapped by YAG easily. Like cleaning dirty windows, brilliant!
Bookwoman MsJ101
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You can have PCO without it interfering with your vision (I do). It all depends on the severity. It's certainly possible that everyone 'gets it', but not everyone's vision is affected by it.
RonAKA MsJ101
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The true YAG rate may not be as high as often claimed. It seems that Ophthalmologists may use YAG as a "cure all" for issues other than PCO. This study suggest the true rate of YAG may be actually as low as 8.5% when issues other than true PCO are excluded.
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Evaluation of Nd:YAG Laser Capsulotomy Rates in a Real-Life Population
Roland Ling,1 Eva-Maria Borkenstein,2 and Andreas F Borkenstein2 Published online 2020 Oct 13
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If you are concerned about PCO there are a couple of things to consider. One of the prevention measures is for the surgeon to clean/polish the capsule after the lens removal. Another is the use of IOLs with a square sharp edge. The new Clareon monofocal has an improved edge design that is claimed to reduce the incidence of PCO. I believe there is a Clareon version of the Vivity now, but I have not seen information on whether or not it has an improved edge design or not. See this for more detail on the Clareon monofocal. Keep in mind that a sharper edge design can increase the risk for positive dysphotopsia. But, I think the risk and impact is low. I have an AcrySof IQ monofocal in one eye and a Clareon in the other. I do have an occasional incident of dysphotopsia with the AcrySoft, but after 11 months with the Clareon I have none. No issues with PCO in either of them. The AcrySof lens has been in about 2.5 years now.
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The Open Ophthalmology Journal Comparison of Visual Outcomes and Patient Satisfaction Following Cataract Surgery with Two Monofocal Intraocular Lenses: Clareon® vs AcrySof® IQ Monofocal Smita Agarwal1, Erin Thornell2
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For what it is worth I considered hybrid monovision with a Vivity in my near eye set to -1.0 D, and a monofocal at -0.25 D in my distance eye. At the last minute along with advice from my surgeon I went with a monofocal in both eyes. Due to the time of surgery and availability of lenses, I ended up with an AcrySof IQ monofocal with a SE outcome of -0.25 in my distance eye, and a Clareon monofocal with an SE outcome of -1.40 D in my near eye. I am quite satisfied with the results. I am essentially eyeglasses free. In a perfect world I think 0.0 D n the distance eye, and -1.50 D in the near eye with 0.0 D astigmatism would be the ultimate, but it is not a perfect world.
soks MsJ101
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why one of eyhance and one of vivity?
MsJ101 soks
Posted
The Vivity in my dominant (distance) eye for good distanceand intermediate vision, and the monofocal for better reading. Though now with this option, I would go with an Alcon monofocal as I've seen several doctors say mixing can work fine but stay within one brand and they'll work together better.
My doctor is lukewarm on this, but he's also reluctant to increase the correction of a 2nd Vivity in my non-dominant eye to give me the great reading ability I currently have with contact lens monovision.
He still thinks the PanOptix in both eyes is the best choice for me, but my gut tells me no. So it's all still up in the air. 3 weeks to my scheduled 1st surgery.
This is such a tough decision.
soks MsJ101
Posted
get panoptix and clareon monofocal.
RonAKA MsJ101
Posted
I seriously considered and was very close to doing a combination of a monofocal and Vivity lens. However, I was going with a monofocal in the distance eye, and a Vivity in the near eye. My reasons were that the Vivity compromises distance vision somewhat, and compromises contrast sensitivity even more. I wanted to be sure I had good distance vision for driving and especially at night. The monofocal delivers peak visual acuity and contrast sensitivity when set for distance. It can make up for the compromised contrast sensitivity with the Vivity. The advantage of the Vivity in the near eye is that it does not have to be offset as much for good mini-monovision. It provides about 0.5 D of extended depth of focus over a monofocal, so can be offset by 0.5 D less. I was going to go ahead with a Vivity in my near eye offset to leave me -1.0 D myopic. When you offset by this much you retain a little more distance vision in the near eye. I ended up going with a monofocal in the near eye with an offset to -1.4 D. I don't miss the extra distance vision in the near eye.
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I have no regrets and really like my mini-monovision using two monofocal lenses.
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I can't think of any reason not to mix brands of lenses, although Alcon lenses typically have blue light filtering, and J&J ones are clear. The real issue may be that surgeons get locked into one brand or the other and don't deal with two different suppliers of lenses.
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Some people like Vivity, and some even like PanOptix. But, you risk halos with the Vivity, and even worse than just halos with the PanOptix. If you have experience with contact monovision you will like monovision with an IOLs. It is easily your lowest risk option.
karbonbee MsJ101
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"The Vivity in my dominant (distance) eye for good distanceand intermediate vision, and the monofocal for better reading."
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I think you would get better results by switching those around... The monofocal will give you much better distance vision, and targeting some myopia with the Vivity will give you good near and intermediate vision without losing too much distance vision. And if you end up with visual disturbances or loss of contrast with the Vivity, having the monofocal set to distance will help to compensate better in this configuration.