Proper Pre-operative procedures for Visian ICL?

April 21, 2015

QUESTION:

I had lasik surgery 3 weeks ago and was told I was both nearsighted and farsighted. If PRK was performed, would that correct both nearsightedness and farsightedness as well as my astigmatism?

 

 ANSWER:

It is impossible to be both nearsighted and farsighted in the same eye.  It is like a number being both positive and negative at once.  More likely, you were nearsighted with presbyopia.  Many people confuse presbyopia with farsightedness.  Presbyopia is the aging of the lens inside the eye which happens to all people in their 40’s, and it causes a need for reading glasses.  If you were nearsighted with presbyopia, and you had PRK, you would have had two options with surgery.  One would be a full correction of your nearsightedness in both eyes, to give you excellent distance vision.  You would remain presbyopic, and would need glasses for close work.  The second option would be monovision, where the nearsightedness is fully corrected in one eye (usually the dominant eye), and partially corrected the the other eye.  Leaving one eye slightly nearsighted helps “get around” the problem of presbyopia, and allows you to see near better without using glasses.  Most people adapt very well to monovision and don’t notice any tradeoffs.  Some notice minor tradeoffs but decide that it is well worth it to avoid the need for reading glasses.  Astigmatism is treated either way, with the goal of complete elimination whether you do monovision or a full distance correction.  Hopefully your surgeon explained all this to you prior to surgery and allowed you to make a fully informed decision.

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April 21, 2015

QUESTION:

I am 60 yrs. old, having pupils so large they let in too much light.The daily light from the sun makes my eyes water and sting. From a headlight it is also kind of “blinding”. I am also very farsighted(?).

 ANSWER:

If you are extremely farsighted, you might want to consider a procedure called Refractive Lens Exchange.  This procedure is similar to cataract surgery, where the natural lens inside the eye is removed and replaced with an artificial lens implant.  Advanced lens implant styles now available offer patients the ability to see both near and far without glasses.  A side benefit is that by having your lens removed, you will not develop cataracts as you get older.

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April 21, 2015

QUESTION:

My spherical power is -7.25 and cylinder is -1.25with 10 degree axis in right eye and spherical power is -5.5 and cylinder is -2 with 170 degree axis in left eye in which i have undergone barrage laser for lattice…and my corneal thickness is about 611 in both eyes..what is the best procedure to get rid of my glasses?

 ANSWER:

With your prescription and corneal thickness, assuming the shape of your corneas is normal, I would recommend LASIK as the procedure of choice for you.  Lattice degeneration is not a contraindication for LASIK.

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April 21, 2015

QUESTION:

I’ve noticed that some doctors perform the iridotomy a few days or a week prior to the ICL implantation, but my doctor wants to do it on the same day. I also see that dome doctors prescribe antibiotic drops to be taken a day prior to the surgery; mine didn’t. Some recommend no make-up etc. for several days prior. My instructions were only: don’t wear contacts and don’t put any lotion, etc. on the day of the procedure. Also, my doctor wants to do both eyes on the same day. Should I be concerned?

ANSWER:

There is no absolute right or wrong way to handle some of the issues you raise regarding Visian ICL.  Some physicians will perform iridotomies in advance and some at the time of ICL implantation.  Similarly, some pretreat with antibiotics and some don’t.  Nearly all will advise against makeup on the day of surgery and some for a few days even before that.  Some will do the two eyes separately and some will perform bilateral implantation.  If your surgeon is well trained, experienced with ICL, and you are comfortable with him/her, you should not be concerned.

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