Questions about IOL replacement

Posted , 5 users are following.

I'm wondering if there is any hope that I'll adjust to this offset between my eyes. I had no experience with monovision of any kind and did not do a contact lens trial due to the advanced nature of my cataracts. My -1.5D IOL was implanted on Oct 5 and -1.0D IOL on December 7. When I went to see my primary care doctor about my big toe following a fall (it is sprained, not broken) I hit the edge of the step onto the scale... Basically, my -1.5D eye seems blind. I had thought that with such a small offset, my -1.0D eye would take over, but that's not the case for me. So I'm interested in replacing my -1.5D IOL with another -1.0D IOL, but since it was implanted on Dec 5, is it too late? If not too late, how would I best locate a surgeon with the skills to do a replacement? I'd appreciate hearing about IOL replacement experiences among group members. Thank you.

0 likes, 6 replies

6 Replies

  • Edited

    I think you're getting ahead of yourself. It hasn't even been a month since your second lens was implanted, so a) that eye hasn't fully healed yet and b) your brain hasn't had a whole lot of time to adjust to your new vision. Half a diopter difference is really small, and in any event you won't know where you've actually ended up until you have your refraction done in January. Take a deep breath, let your eyes adjust, and then see where you stand...(rather than fall!)

  • Edited

    A few comments...

    .

    I think it is premature to conclude that your most recently operated eye is actually at -1.0 D. You probably recall you were posting that your first eye was at -2.0 D, until you had an accurate post recovery refraction done that determined it was at -1.50 on a spherical equivalent basis. I would defer any decisions on the eye until a similar post recovery refraction is done to determine exactly where it landed.

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    IF there is a 0.50 D differential between the two eyes, this is a near insignificant differential. You should be able to handle up to a 1.50 D differential without having any ill effects.

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    At your post recovery refraction you should ask the optometrist if there is any evidence of posterior capsule opacification (PCO) in the -1.50 D eye. It is not common but in some cases PCO can develop quite rapidly. It is sometimes called a secondary cataract as it looks like a cataract, but it is not a cataract at all. Cataracts cannot develop in an IOL eye. PCO could be the cause of your reduced vision in that eye.

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    Your vision at 4-5 feet to your feet in the -1.50 D eye should be pretty good at about 20/32, and should not be any cause for vision issues at your feet distance.

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    There is no rush to consider a lens exchange, and in any case I would not recommend it. You have selected IOLs to give you intermediate vision. Prescription glasses are required with that choice. Instead I would suggest you get progressive prescription glasses after your post recovery refraction.

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    You may want to consider some eye exercises for monovision, although you have a trivial amount of monovision. Google this to get a video about it.

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    YouTube How to get the best from Monovision Wellington Eye Clinic

  • Edited

    There is no rush to change the lens. And, you may have a hard time finding a surgeon that is willing to explant the lens for such a minor change. Things can go wrong with explants, and they may decide the risk of the exchange is not worth putting their reputation at risk.

  • Edited

    Judith

    I totally agree with Ron and Bookwoman. I know your are kind of on the worrying/anxious side ( so am I and so are a lot of other people), but give yourself time to adjust to your new lens. A pair of eyeglasses should help if you continue to have vision issues. Don't even think about an explantation. Slow down.

    It's going to be all right. Really.

  • Edited

    you are unsettled because of the fall. i completely understand. 3 years ago i fell on the stairs due to poor vision and dragged my 6 year old with me as i was holding his hand. i was 45 at the time. fortunately we didnt break any bones but i was badly hurt.

    please check if you are blind in the -1.5 even after wearing -1.5 glasses. if yes then you need to investigate. i agree with others that -0.5 is nothing difference. that's the natural difference in my eyes all my life. -2 and -2.5.

    i have had an explant and it is not a straightforward surgery. it can induce significant astigmatism. cause epithelial cell loss. damage the cornea. cause zonular dehiscence. i had sutures after the explant for holding the astigmatism. then a suture got lose and started hurting so i had to get them removed after 12 weeks. also the capsule has already contracted in 3 months so the new iol is really held in place by the shrunk capsule rather than the capsule shrink wrapping against the iol. although the vision in my explanted eye is better than the other eye.

    so make that decision only if the vision is unbearable and after careful consideration. and going to -1 from -1.5 wont help. you may have to go plano if you are unhappy. take it easy till your refraction and see how the vision settles. if you are in the US you can order both myopia and reading glasses in amazon. good luck.

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