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?

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  • Posted

    Following this thread. I had two symphony lenses put in October 2017. Had yag done on both eyes January 2018. Yag busted up opacification stuff but now in field of vision. They said most people goes away. I am due to have a vitrecomy this Thursday to remove vitreous. Thoughts and any info much appreciated
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    • Posted

      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.

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  • Posted

    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.

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    • Posted

      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.

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  • Posted

    The flickering like when you move your eyes around? I feel like my flickering is from post tag debris and the light going around them?
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  • Posted

    My flickering was on the (outside) edge of my vision and was particularly bad when a bright light source was coming from the side. For further information you may want to find the discussion about flickering on this website which has numerous posts going on for years now.
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    • Posted

      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.

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    • Posted

      pg128 that flickering can also be the light catching square edge of IOL.  Happens less with a round edge IOL however round edge IOLs don’t prevent PCO so it is a question of which would you rather.

      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. 

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    • Posted

      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.

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    • Posted

      That’s too bad.  Remind me of what type of IOLs you have?   I would think at that close range all IOLs should be fine.

      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.

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    • Posted

      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) 

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    • Posted

      It may have been your lens of choice anyways.  Not many here on the forums pleased with Symfony lenses I have.  But I ended up with a good result and have no inside issues at all.  Do need good lighting though so if a menu were handed to me in a candlelight environment I’d be shining iPhone flashlight on it to read!). But honestly it’s been fine.  Haven’t needing glasses for distance or near since surgeries and even the nighttime driving had gotten better.  Starbursts and glare diminished a lot over past year and although I still see the concentric circles they are now part of my new landscape and I have adapted and drive at night.  Have to in Canada - gets dark by 4pm in winter.  Attitude helps - I think of it like a high tech scope that one sees in movies where target has multiple rings around it.

      Best wishes to you pg128

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    • Posted

      Hi, I’m having a Vitrectomy on the am and he thinks my flickering will subside due to strands caught in my vitreous. Thoughts?
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    • Posted

      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. 

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