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I posted this on the 7th of August but it has been in moderation and it is now the 10th so I am posting it again. If it gets posted twice, I will attempt to remove the duplicate...
My name is Jorge. I am in the US. I had Lasik in 2004 and vision was great until about 3-4 years ago. I initially saw an opthalmologist who told me that I had a cataract forming in my left eye and another just starting in my right.
I was also told that they were not "ripe" and that I should wait about a year before looking into surgery. It has been about 3 yrs now and the vision in my left eye is really annoying me. I have been trying to drink water and carrot juice and all sorts of other things but the vision continues to worsen. I have done a lot of research on IOLs and it seems clear that in the US our IOL options are very limited compared to what is available in Mexico, Germany, Turkey, Greece and Belgium (probably many other places too).
I was seriously considering traveling to another country to have the surgery done because of the options (trifocals such as the Reviol Tri-ED or the LIght Adjustable Lens. The LAL was developed here in the California yet is still not yet approved by the FDA but I believe it has been available elsewhere since 2009. I hear they are "close" to approving it here).
I am now thinking that I should maybe NOT go elsewhere because if there are any complications or adjustments that need to be done, they would not have any experience with those lenses here and because I had chosen to go around them, may be all too pleased to tell me that I would have to fly back there for them to deal with me.
I would like to ask people who have had Trifocals, multifocals and EDOFs what results they have had. I have been told that none are perfect and that I will have to compromise on one of the following:
• near vision
• intermediate vision
• long distance vision
• night or driving vision (halos and glare)
• low light vision (the ability to see properly in low light situations)
I was told that almost all lenses other than monofocals will produce halos/glare but that after about 3-6 months my brain would adjust and I would not notice them.
I have been dealing with the cataract getting worse and worse for 3 years now, I am wondering if the halows I would see after the surgery could possibly be any worse than how I am seeing now. Maybe it would be a marked improvement!
One doctor told me that that I should try the "small aperture" IOL because by using a small aperture it extends the depth of field. That made sense so I then followed up with a question about low light sensitivity (since just like a camera, you can get almost infinite DOF if you stop the lens down but you then you can almost not see anything unless it is bright daylight), he never responded.
There was another lens, the Reviol Tri-ED. I contacted the author of an article: "The Lens: Reviol Tri-ED” (/). The article made the lens sound great because it had great light distribution. He sent me a research article:
RESEARCH ARTICLE Open Access
Clinical outcomes of a new diffractive
trifocal intraocular lens with Enhanced
Depth of Focus (EDOF)
Banu Torun Acar1*, Erkan Duman2 and Saban Simsek1
Everything sounds great until I ask him:
Besides the Reviol, are there any other IOLs that you recommend to eliminate halos as well as providing continuous focus from close to far?
His response: In Reviol and Zeiss, there are complaints about halo glare. Alcon Panoptics gives us better results.
Keep in mind that this was the doctor who penned the research article that stated:
"All our patients achieved spectacle independence without an incidence of photic phenomena, such as halos and glare at 6 month-follow up."
I cannot ask any of the local doctors what their opinion is on these other lenses because they will only recommend what THEY can do and claim that the FDA only approves the latest and greatest and if they have not approved it, then they are "obviously not having good results overseas".
So at this point, I am completely confused.
1) I can get the surgery done here in the US knowing that there are more advanced and probably better lenses with possibly fewer post surgery abberations and side effects.
2) Go to another country where I will have to stay 1-3 weeks and then hope that when I come home nothing needs anymore work
3) I can go to Mexico and get the LAL but I do not really know how competent they are there. The LAL is adjusted post-op and after your eye has healed (about 2 weeks). Up until your eyes heal, you must wear a pair of UV blocking sunglasses for those 2 weeks so as not to inadvertently expose and thus alter the lenses. After 2 weeks you go back, to the office, they measure your eyes as they are now healed and then adjust the lenses and then once it is dialed in, lock the lens in with another Laser that then prevents any further changes to the lens. The thing about the LAL is that they change shape and can get bigger than when first implanted and if they need to be removed (I don't know under what circumstances you would need them removed) it can be a chalenge since they will be bigger than when they went in.
4) Go to Canada and see what options they have there
5) Go to Greece to visit a doctor who practices both in NY and Greece. If I had to make any changes I would only have to go to New York but that might also be a PITA if I had to do it more than once.
6) Go to New Zealand. There is a doctor there who is one of the few in the world who has worked with the Harmoni lens and I do plan on moving to NZ within 2-3 yrs but that is a much bigger hassle if I have to go there because of the long flight times and their expense.
So, in closing, I would like to hear from people who have had Lasik. I would like to know what type of lens you opted opted for (multifocals or mono) and why. I would like to know if you are happy with them and if you would recommend them.
Thanks in advance and sorry for the long post but I wanted to give as much background as possible.
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