Refractive Cataract Surgery Questions and Answers Archive

Feb
2002

Q&A: Could I be a candidate for LASIK eye surgery if I am myopic, have severe astigmatism and have congenital cataracts?

Question:

I am 50 yrs old, have been wearing eyeglasses since I was 7 yrs. old for myopia. I now also have bifocals. I've also been told I have severe astigmatism and also congenital cataracts. Could I possilby be a candidate for lasik surgery?

- Julie

Answer:

 Andrew Caster, MD, FACS - LocateADoc.com

You may be a candidate. You need to see a Lasik surgeon for a consultation. Andrew Caster, MD

-- Andrew Caster, MD, FACS
Beverly Hills, California



Jan
2002

Q&A: My mother had cataract surgery but now she can see fine until she is in the light, then it pretty much blinds her .Do you know what causes this and what can be done to correct it?

Question:

This question is for my mother not me, she is an elderly woman, who has had cataract surgery, the operation was a sucess. There is only oneproblem, now the light really bothers her, they say she is light sensitive, she has had 6 pair of glasses made in the last year. she can see fine untill she is in the light, then it pretty much blinds her .Do you know what causes this and what can be done to correct it

- Sandra

Answer:

Ernest W. Kornmehl, MD - LocateADoc.com

She should go back and see her Ophthalmologist, to be sure that no Keratitis is present from dry eye.

--Ernest W. Kornmehl, MD
Brookline, Massachusetts



Nov
2001

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

Question:

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

- marco

Answer:

Richard W Lomas, M.D. - LocateADoc.com

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 nothing...in 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



Nov
2001

Q&A: Can a cataract come back after one is removed and an artificial lens is installed?

Question:

Hello, Is it possible to have a cataract return to the same eye that 2 years ago had cataract and artificial lens replacement surgery? This eye has very rapidly(within the last 6 months ) become cloudy again. Thank You

- Bob

Answer:

Andrew Caster, MD, FACS - LocateADoc.com

Sometimes, the membrane behind the artificial lens can become cloudy, causing blurry vision. This can be easily treated witha laser. Andrew Caster, MD

--Andrew Caster, MD, FACS
Beverly Hills, California



Sep
2001

Q&A: After having glaucoma & cataract surgery my vision is foggy. What can I do about it?

Question:

After having Glaucoma & cateract surgery I am experencing foggy condition. What is this called and what can I doe about it?

- Cecil

Answer:

David B. Cano, M.D. - LocateADoc.com

It often takes longer for visual recovery after combined cataract and glaucoma proceedures often because the decrease pressure in the eye can cause both corneal folds and retinal edema in some cases. You may want to have a second opinion from another ophthalmologist (including a retinal specialist) if this does not improve after a month after you

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



Sep
2001

Q&A: I would like to know if Lasek surgery can cause cataracts?

Question:

Dear Dr., I had Lasek surgery less than a year ago. I would like to know if Lasek surgery can cause cataracts? I am 55 years old. Any information or direction would be greatly appreciated. Thank you.

- James

Answer:

David B. Cano, M.D. - LocateADoc.com

LASEK or PRK itself is not a known cause of cataracts as the laser does not penetrat through the cornea. Topical cortico-steroids that are used in refractive procedures can in some cases cause cataracts after prolonged use (many months or years), which is not usually the case with refractive surgery.

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



Jun
2001

Q&A: What experience should an Ophthalmologist have in order to perform Excimer Laser surgery and what can I expect to pay for both eyes?

Question:

REF: Excimer Laser What experience should an ophtalmology have with this procedure regarding the number of surgeries done? What price am I looking for both eyes? What are the positives ? What are the negatives of this procedure. No other disease process is involved.

- Bill

Answer:

David B. Cano, M.D. - LocateADoc.com

Dear Bill, You should find an ophthalmologist that has formal corneal and refractive fellowship training and is board certified. He should be involved in your care from your initial evaluation for surgery, and your post-operative care along with the actual surgery. He should have certification and experience with the lasers that he is using. High volume does not mean high quality! Price should not be your concern, because this is a once in a lifetime procedure and you only want the best for you. In general it is about $2000 an eye by a good surgeon. If you are a good candidate there are a lot of positives for having the surgery including reducing your dependence on glasses and contact lenses. As far as the negatives - there are many that you need to be aware of if you are not a good candidate and a good surgeon and his/her staff will usually educate you about these at your initial evaluation, which is usually complimentary. Your eyes should be healthy without other diseases like dry eyes, infections, cataracts, glaucoma, retina problems, etc. David B. Cano, M.D. W. Palm Beach, FL www.Canovision.com

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



Jun
2001

Q&A: With me having to take Coumadin am I safe to have the Laser Vision Correction?

Question:

With me having to take Coumadin am I safe to have the Laser Vision Correction. This is something I'm interested in but don't know when I'll be able to. JL Stroud

- jennifer

Answer:

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

Because Coumadin is a blood thinner it may increase the potential for a reported serious LASIK complication, a subretinal/submacular hemorhage. People on bloodthinners should consider other means of refractive surgery if they are suitable candidates.(PRK/LASEK) Another option would be to come off the bloodthinners if you get the blessing of the doctor that prescribed them. Do not stop your blood thinners without consulting your primary medical doctor.

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



Aug
2000

Q&A: What should be done if my aunts eyes water and it looks like sugar water?

Question:

My aunt had cataract surgery that helped her for 3 years. Then she had laser surgery that helped another 3 years. Now her eyes are always watery. She says it's like sugar water. Her sight is almost gone. What can be done for her? She is in her 70's.

- Dan

Answer:

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

Take her to a cornea specialist to evaluate the tearing.

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



Jul
2000

Q&A: What should I do if my doctor performed LASIK (double carding) and now wants to performance more surgery?

Question:

DEAR DOCTORS I HAD LASIK SURGERY 4 MONTHS AGO AND MY PRESCRIPTION WAS OD -2.00 +3.00 X 95 OS -1.75 +3.25 X 85 HYPEROPIC ASTIG? OR MIXED ASTIG? MY DOCTOR PERFORMED A DOUBLE PROCEDURE ON MY EYES (DOUBLE CARDING)WITH THE SUMMIT APEX PLUS) I AM CURRENTLY SEEING 20/50 AND MY DOCTOR IS CONSIDERING AN ENHANCEMENT (VERY SCARED) MY QUESTION IS WHY ARE SOME DOCS PEROFORMING DOUBLE CARDING AND SOME DOCS ARE WAITING FOR THE FDA APPROVAL OF HYP ASTIG TREATMENT? I FEEL LIKE I HAVE JUMPED THE GUN AND MADE A MISTAKE. I HAVE SOME ASTIG LEFT WITH SOME MYOPIA NOW. MY DOCTOR TO DATE HAS NOT PERFORMED A TOPO ON ME. ANY TYPE OF RESPONSE WOULD BE APPRECIATED. THANKS JO ANN CISSELL

Answer:

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

It is hard for me to believe that there are ophthalmologists who do not know that the bitoric treatments give a far superior visual result than "double carding." There are some cases when double carding may be appropriate, but this is the exception. In our practice the patient's best interest is our chief motivation for recomending procedure(s). We place patients with your refractive error on a list so we can treat them the way we would want to be treated. We are not desperate for surgery to do, and we are not motivated by our own economic considerations. I am sorry you are having an outcome that is less than what you could have had. I would go to another surgeon for the rest of your care.

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



Dec
1999

Q&A: Would my wife be a candidate for laser vision correction with a nearsightedness of -18 and retina reattachment?

Question:

My wife is very near-sighted (-18) she has had both retina' re-attached and has significant thining of the retina. Her vision w/contacts is quite good,about 20/20, but when she needs to wear glasses it is a problem. It is very difficult to fit her w/glasses because of the required correction. The laser procedure sounds as if it may improve her ability to wear glasses (at least more normal ones). My concern is what potential negative issue may we be looking at because of the severity of her vision problem? She is 40 yrs old and her eyes are quite healthy, as is the rest of her. The retina surgury was about three years ago & she has had no difficulty since then.

- Mike

Answer:

John D. Zdral, M.D. - LocateADoc.com

Your question is a good one, the -18.00 prescription is beyond the range of laser correction, which has it's maximum at -12 to -13 diopters. If she were treated, her residual correction would be approximately -6.00 diopters, a vast improvement over her current situation; but still fairly near sighted. One other option would be cataract extraction with a lens implant, if there was any trace of cataract formation (not uncommon after retinal surgery). A new lens implant would allow her to correct all of her nearsightedness. Lens implants (without cataract surgery) are still being investigated, but may be available in 2 years time. Please contact the office if you wish to schedule a consultation. Our phone number is 1-800-824-1073.

--John D. Zdral, M.D.
Fullerton, California