Piggyback lenses vs Lasik/Lasek/Smile
Posted , 6 users are following.
As I approach another vitrectomy after having one on each eye combined with IOL, I need to consider correcting my monofocal IOL outcome at the same time.
The initial target was a mildly myopic prescription to give some intermediate & arms length vision as I had with my natural lenses. However I now find that vitrectomy and IOL surgery combined makes calculations tricky as eye shape (axial length especially which is key to power) can change for at least a year post surgery.
The upshot is my initially under myopic result is moving ever more overly myopic and I am finding contact lenses (multifocal or standard) difficult to wear and get reasonable vision with. I also have very bad starbursts, dysphotopsias and a strange circle around light sources in low light like a Symfony IOL circle but larger, so its not been great all told.
My surgeon has suggested piggy back lenses to put the vision back nearer where I wanted as these will avoid worsening comfort issues with contact lenses.
Has anyone had piggyback lenses and if so how did it go?
0 likes, 14 replies
george05887 pg128
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pg128 george05887
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Your experience is why I opted for vitrectomy (needed for severe floaters), IOL and cutting rear of capsule all combined to avoid debris from YAG etc. However as I've found it affects target prescriptions so perhaps there is no best plan.
peter1110 pg128
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I had a piggyback lens installed to try to reduce or eliminate very annoying flickering I had. The surgery went OK, supposedly was a simple as the original IOL operation. It did markedly reduce the flickering, but made the starbursts, halos etc I see around bright lights, worse. I was told by a 2nd opinion doc that the surgeon didn't get the piggyback perfectly centered and that may account for making the starbursts etc worse.
pg128 peter1110
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I also have flickering in one of my eyes with no explanation from my surgeon (in the corner and worse in bright light).
I suspect my starbursts which are worse in the other eye may be IOL position related but haven't got a second opinion yet as I still need the services of a vitreo-retinal specialist like the original surgeon and they're not common compared to IOL only surgeons. Additionally if the original lens is off position then there's nothing I can do anyway as the capsule was cut front and back during insertion to avoid YAG for PCO which is almost a definite for vitrectomy patients.
george05887 pg128
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peter1110 pg128
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pg128 peter1110
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That's exactly what I see although compared to my other visual issues from my IOLs it's not too bad. My surgeon said they used to think the flickering was vitreous related but given I've had a vitrectomy doesn't know.
I only want piggyback lenses to correct the increasing myopia (wish I had gone distance/intermediate now) but every procedure seems to bring more risks and complications.
Sue.An pg128
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I had a bit of that in the early months after surgery (LE) whereas no experience of that flickering with RE after surgery. It could be as you say IOL positioned slightly differently. Now 11 months since LE surgery I don’t notice the flickering.
pg128 Sue.An
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Thanks for the info.
I had no chance of PCO as the surgeon cut the posterior capsule during implantation to avoid potential debris from YAG (given I had vitrectomy for severe floaters). In the grand scheme of my issues the flickering is low down on the list as the huge starbursts are worse.
My wife and I attempted a nice candlelit meal and gave up (on the candles) when I couldn't manage the starbursts no matter where we put them.
Sue.An pg128
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wondering if the astigmatism plays a role - would you know if you have much astigmatism? Seems to be a correlation between astigmatism and near vision/reading and glare/starbursts one experiences.
If you’ve not been to an optometrist for exact prescription I would encourage you to go. They can correct astigmatism with glasses and that might fix the issue. I do t have much after cataract surgery .25 in RE and .50 in LE but I did get a pair of sunglasses (no power as my eyes are both plano but to correct astigmatism). Find in bright sunshine and especially driving they are a welcome help.
pg128 Sue.An
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I chose Tecnis ZCB00 monofocals specifically to give sharp vision with contacts/glasses at various distances, and reduce night time issues. Cost wasn't a factor but my surgeon wasn't very helpful on IOL choice but then not many vitreo-retinal specialists are and that's what I needed for the vitrectomy aspect.
I've had numerous optometrists checks as my prescription keeps changing even after 6 months due to but currently only have about -0.5D astigmatism in both eyes now (one had 0D two months post surgery, the other -1D)
Sue.An pg128
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Best wishes to you pg128
george05887 pg128
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pg128 george05887
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How did your surgery go and did it help the flickering?
My flickering seems to be triggered by light level, so I am wondering if mine is retinal damage near the edge. Both my vitrectomies had cryo freezing to 'fix down' some dubious areas of retina but that's all the detail I got. I think there are so many variables with vitrectomy/IOL/PCO etc that its hard to compare and surgeons (especially vitreo-retinal rather than IOL only) consider being able to see reasonably a good result.
Prior to vitrectomy I had read that axial length reduces for up to a year after (which increases myopia) but my surgeon disagreed but now 5 and 8 months in it has been the case for me and I could have allowed for this in lens power choice.
My surgeon wouldn't make any lens recommendations for power or type so left that to me and I went with what I knew for target which he said was a reasonable plan, but in the end the target was missed by a fair margin.