So, you had your LASIK surgery done many years ago, and have since enjoyed excellent vision without the need of glasses or contacts. You recently notice your vision is getting blurry and you think the LASIK is “wearing off.” You go to your ophthalmologist and are told your vision is deteriorating because you have developed cataracts! Now, what do you do?
For many, the formation of cataracts is a natural part of the aging process, causing the eye’s natural lens to cloud and distort vision. The lens is held inside a capsule, and is made of mostly protein fibers and water arranged precisely so as to permit light to pass through without interference. Over time, these fibers begin to break down and cluster together, clouding the lens. As more fibers break down, the clouding becomes denser and covers a greater area of the lens. Cataract Surgery becomes necessary to restore clear vision. Visually significant cataracts can be easily removed and replaced with an IntraOcular lens implant (IOL) on an outpatient basis.
Let’s first discuss some facts and misconceptions concerning LASIK and cataracts:
- LASIK DOES NOT increase or decrease the likelihood of developing cataracts.
- LASIK DOES NOT prevent one from having cataract surgery.
- LASIK DOES NOT make cataract surgery more difficult, or risky.
- LASIK DOES make the calculation of the correct IOL power less accurate.
- LASIK CAN be repeated following cataract surgery to fine tune vision.
Because of the added intricacies involved in cataract surgery in the LASIK patient, it is very important to seek the advice of an ophthalmologist specializing in both LASIK and refractive surgery. In the past, the goal of cataract surgery was to improve one’s best corrected vision, the goal was not to be glasses free following surgery. General cataract surgeons are not as well versed in the demands and issues of the LASIK/cataract patient, namely the desire to remain spectacle free following surgery.
The goal of the refractive cataract surgeon is to both improve the patients vision, and to help them to remain independent of glasses as much as possible. This is attained through careful calculations to determine the proper IOL power, meticulous cataract surgery, the use of a variety of IOL’s such as multifocals (ReStor and Technis Multifocal) and accommodating (Crystalens) which allow one to see both near and far without glasses, and the use of the excimer LASER to fine tune vision following cataract surgery.
Before cataract surgery, measurements are taken of the eye, including its length and curveature. These measurements are used in a complex equation to determine the proper IOL power. As I previously mentioned, prior LASIK surgery makes these calculations less accurate. These calculations can improve if we have access to several measurements from before the initial LASIK surgery. Unfortunately, many patients have had their LASIK surgery over a decade ago, have not seen their operating surgeon in many years, and have had their records purged due to chart inactivity.
Because these measurements are so important, we at EyeCare 20/20 are in the process of sending all of our previous refractive patients this information to keep for future reference. To aid any patient who has had refractive surgery done in the past elsewhere, we are making our form available to all. Simply download this Refractive Surgery History form and ask your operating surgeon to complete it. Keep it in a safe place for that day you too will need cataract surgery.
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