Travel to Another Country to Get the Lens I Want - How to Get Info?
Posted , 6 users are following.
I live in the USA, where (according to my opthalmologist) you can't get a toric IOL with more than 6 cylinder. I need 10. So, it seems I have to go to another country for my surgery to get the lens I need.
In Europe, Zeiss, HumanOptics, Teleon and possibly others offer the high cylinder power I need.
If I travelled to Germany, I would probably have full choice. That's pretty inconvenient, but I would do it, if that's my best option. I'd rather go to Canada. Second choice, any other English-speaking country. Third choice, a Spanish-speaking country (my Spanish is pretty good). My wife has a bit of French and a bit of German (very little) so that would help. I understand a lot Europeans go to Eastern Europe or Turkey to save money on cataract surgery.
My question is, how could I get comprehensive information on what lenses are available where?
I have been focused just on the high-cylinder issue. But now I'm getting greedy and wanting extended depth of focus too.I use the computer a lot.
HumanOptics does not seem to have EDOF Toric.
Zeiss does (AT Lara 929), and it sells in Canada, but it does not seem to sell its Toric EDOF lens there.
I am just beginning to research Teleon. (MPlusX Toric)
It's hard to find information. I've asked my US opthalmologist. He says he'll work on it.
I've contacted opthalmologists in other countries, and gotten useful bits and pieces of information this way.But it's slow going.
I've also tried contacting the companies, with mixed results.
Is there an easier way to find out what lenses are offered where?
0 likes, 9 replies
Myope_PSC jimluck
Edited
Just a note about Teleon. If considering Teleon I think it's worth knowing about Oculentis. Search for "Oculentis Reports Bankruptcy as Legal Challenges Mount"
Oculentis issued recalls in 2014 and 2017 because of increased rates of postoperative opacification in certain models. They filed for bankruptcy late last year.
I think the lenses are obtained through Clarion Medical in Canada.
Hopefully the manufacturing issues have been resolved and hopefully all patients that were affected will be responsibly and adequately taken care of.
The Rayner 623T toric monofocal with up to 11D cylinder and the Zeiss Torbi 709MP monofocal with up to 11D cylinder should be available across Canada as custom orders. Same applies to the Zeiss Trifocal 939MP.
Search for "Specialty-FH-IOL-Consent-form-July-22,-2021.pdf" to get a list of lenses available in BC last year to get an idea of availability. It's probably similar in other provinces.
Maybe also search for Ike Ahmed and Prism Eye Institue. His name shows up on a lot of eye surgery related studies on PubMed. He's apparently quite accomplished and world renowned.
Get a good and realistic idea of what outcome to expect. Success with an EDOF is probably very dependent on having low astigmatism after surgery. A monofocal would seem to be the safer bet if left with moderate astigmatism but you need to get that info from a surgeon.
jimluck Myope_PSC
Edited
Thank you. This is the type of helpful reply I was hoping for. That list is amazing! Great resource. How do I find comparable lists in other countries, I wonder. (Funny aside: At first I was reading "LISA" -- which is a name Zeiss uses for some lenses -- on that list as "USA" because with my poor computer vision the "L" and the "I" merged into a squared-cornered "U").
I have an inquiry in with Prism from a few days ago. Waiting to hear back.
It may be that mini monovision is a better option for me than an EDOF. I've played around with that at home with a +1.0d lens over my glasses and it totally works. I don't even notice that one eye is fuzzy with both eyes open. I just experience it as extended depth of focus in binocular vision. But, I'm doing it with progressives, so I don't know what the progressiveness is contributing. I have some monofocal glasses on order with my astigmatism correction and that will facilitate experiments. Expensive -- new lenses put into old frames I had in my closet cost over $400 because of my challenging prescription. But worth it to me.
Still, it's interesting that Zeiss offers up to 12 cyl on its trifocal.
rwbil jimluck
Posted
I am not an Astigmatism expert but 6 D of astigmatism is pretty severe and you are at 10 D. And then there is the issue of regular vs irregular astigmatism. There are other methods to deal with Astigmatism than just a toric IOL, but my best advice is to find a top ophthalmologists in this area before going to another country and trying some IOL you never heard of.
jimluck rwbil
Posted
Mine is regular in the center, throughout the radius that is relevant for vision, my ophthalmologist says. There is a big beer belly in my cornea lower down, but that's not the part I look through.
jimluck
Edited
I am currently seeing a top ophthalmologist, associated with Harvard Medical School. I will do this in concert with him unless I find another local one I like better (I have an initial appointment scheduled at Mass Eye and Ear with another Harvard Med School doctor for a second opinion).
My total astigmatism is 8.25 at the corneal plane, based on my glasses prescription. The topo says the cornea component of it is 7, so the other 1.25 is in the lens which will be removed. 7 at the corneal plane requires 10 at the IOL plane my ophthalmologist says. The best he can do for me is 6 plus strong glasses.
Yes, the cylinder I need is a lot. It is due to pellucid marginal degeneration. If I'm going to have something surgically implanted, I would like it to do the whole job, if possible.
Another avenue I am pursuing is a non-toric IOL plus scleral contacts. I'm going to try out the scleral contacts for a while before surgery and see if I think it's realistic to plan on daily use. They are supposed to be very comfortable and give better vision than anything (except another hard contact) for severe astigmatism. The are large hard contacts that only touch the whites of the eye, vaulting over the iris. The vault is filled with fluid before you insert them, and the fluid conforms to the irregularities in the cornea so that they no long distort your vision. If you're going to wear scleral contacts, you don't want toric IOLs correcting an error that won't be there once the contact lens is in. I came up with this plan through independent research, but my ophthalmologist thinks it's a good plan.
I never heard of any IOL until recently. Now I've heard of many, within a short time interval, some approved here and some not. But what I have heard of or not is irrelevant, as I am a layman.It's what people who know about this stuff think that will guide me.
My ophthalmologist has not expressed any misgivings about my plan to find the right lens and a skilled surgeon abroad and has agreed to help me to do it. As a first step he is contacting a top ophthalmologist in Canada that I found. It turns out, he already knows the guy. I guess the world's top ophthalmologists tend to know each other. I could just sit back and let that take its course, but it was only by my being proactive that I stimulated this consultation. So, I'm not done being proactive. I am searching out other lenses and other doctors to suggest to my ophthalmologist for follow-up.
rwbil jimluck
Posted
Many of the top Opthalmologist do clinical trials, publish paper and do seminars, so they travel and meet other top Opthalmologist from other countries.
One concern is if you get an IOL not available in the US, it might be hard to find a doctor familiar with that IOL for your follow up or is you have issues with it. This would be especially true if it is a very different type of IOL. So I think it is a good idea if you work with an Opthalmologist that knows what your are planning or better yet assist in the process and is good doing all the follow ups with that IOL.
RonAKA jimluck
Posted
The company sales people will know who is implanting their lenses, but getting them to give you that information may be difficult. They are used to only talking to surgeons, not patients.
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My wife had a need for a toric lens with a higher cylinder than what was available. She got the maximum available, but we don't know what the outcome really was as she has amblyopia and she did not get enough improvement that she could even see the "E" on the eye chart. But, what it might suggest is that you consider getting the maximum available cylinder power from a trusted surgeon, and then deal with the rest of it with glasses. From what I read it is not a slam dunk to correct these extreme levels of astigmatism to a no eyeglass level. So the realistic outcome may be that you will need glasses anyway, so why try to correct it all with the IOL. Leave the residual to eyeglasses.
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Here is an article you may want to look at. It talks about using the Tecnis ZCT600.
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CRST Succeeding With Toric IOLs in High Astigmatism Francis S. Mah, MD
Night-Hawk RonAKA
Posted
My right eye cataract surgery was performed by that Dr. Mah - he uses a method that reduces the amount of eyedrops needed after surgery. I got the Tecnis toric monofocal with about 3D cylinder, but I was left with about 1D cylinder of remaining astigmatism in that eye. The cylinder now is at a way different angle than originally so I believe the toric IOL did reduce the original axis astigmatism nearly completely but an additional astimatism at a different axis was introduced from the corneal incision. That makes it unpredictable how much residual astigmatism you may get. Even with 1D cylinder though I get pretty good distance vision in that eye now, 20/25 or so uncorrected and almost 20/15 with glasses correction of the cylinder - the sphere came out within 0.25D of the target.
jimluck RonAKA
Posted
Thanks. If I go with 6 cyl, I will still have remarkably high astigmatism as my residual astigmatism. That means a thick, expensive lens, linear distortions, and not being able to use non-prescription reading glasses. I will probably elect to postpone surgery as long as possible if that's the projected outcome. I'm not having any trouble driving at night. The docs say they say significant cataracts, but my only complaint with my vision is near and intermediate focus unless I get everything just right (distance, head angle, lighting).