Presbyopia Surgery Questions and Answers Archive


Q&A: How would an IOL (intraocular lens implant) affect me as a firefighter?


I work as a firefighter how a IOL can affect me. while Iam performing my duties

- marco


 Richard W Lomas, M.D. -

An IOL (intraocular lens implant) is used to resolve cataracts or, in rare cases, to correct vision for someone whose myopia or hyperopia is so extreme as to preclude them from having a LASIK procedure. We have performed over 10,000 IOL procedures for both cataract and refractive corrections. However LASIK can correct nearly any prescription today- up to -16.00 diopters of myopia (nearsightedness), +5.00 diopters of hyperopia(farsightedness), and 5.00 diopters of astigmatism; therefore IOL's for vision correction are seldom used. This procedure involves removing the natural lens of the eye, and replacing it with an artificial lens. If you have a cataract, the alternative is to do which case the cataract will certainly worsen until vision is lost. Surgery is pretty much a necessity for cataract patients. Removing the natural lens also removes the ability to change focus from distance to near vision, and the patient would require glasses for all close, and possibly midrange tasks. For this reason we do not recommend implants as refractive devices (to eliminate glasses) on those who are under 40. People who are much over 40 will already suffer loss of close vision that comes naturally with age (presbyopia) and would require reading glasses anyway. LASIK is generally considered the better option for surgical vision correction (in non-cataract patients) when it is possible, as IOL surgery is much more invasive, somewhat more risky, and a great deal more costly. If you have been advised to have lens implants for refractive correction, I strongly urge you to get a second opinion to insure that this is your only option. If you are in Washington, I invite you to come for a free evaluation, we will be happy to clarify what your options are. As far as the effect on your work, the IOL may cause some reflections, especially at night. a few people experience this and find it annoying, most do not notice it. Because the IOL is inside the eye, you will not see or feel it, nor should it affect your ability to do any task with the exception of close work for which you would need reading glasses.

-- Richard W Lomas, M.D.
Renton, Washington


Q&A: While my sight is not really bad, I do have slightly blurred vision, especially when reading small print. What should I be doing to stop this continuing problem?


While my sight is not really bad, I do have slightly blur vison especially when reading small print. What should I be doing to stop this continuing problem?

- Daniel


David B. Cano, M.D. -

You may have been overcorrected with your surgery and may require retreatment or if over forty you may simply have developed presbyopia and require reading glasses.

--David B. Cano, M.D.
West Palm Beach, Florida


Q&A: If my main problem is astigmatism, how do I decide if and when (age-wise) to have LASIK eye surgery?


Dear sir, I am considering having lasik surgery done to clear up my astigmatism. I read that if I have a certain type of vision problem, that often when a person gets older and starts to lose his vision do to age, the two problems being the oposite of each other balance themselves out. If I have this certain type of vision problem and have lasik surgery done, then when I get older and start to lose my vision due to age, the two problems will not balance each other out because I would have already eliminated one of the problems. Therefore I will be left with a vision problem due to old age and once again continue to have to use glasses. The story I read did not explain exactly which vision problem it was that balances itself with age so I can check if it is the problem I have. Is all this true? Can you explain a little more in detail how this balancing process works and if i'm better off waiting ? I'm 31 years old now. Thank you very much. Tobias Maes


Byron Stratas, M.D., F.A.C.S. -

If astigmatism is your main problem, and if you need glasses for most or all tasks at distance and near, then you are not losing much. Presbyopia affects everyone ~40 y/o and gets worse with age. You will have to deal with it wether you have LASIK or not. People with low amounts of myopia (with little or no astigmatism) can take their glasses off to read. Those people need to understand that having their distance vision corrected means they will need glasses for reading. The best way to decide is to think about when you would prefer to wear glasses.

--Byron Stratas, M.D., F.A.C.S.
Wilmington, North Carolina