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Eye Care Archive (Expert Forum)
Continued intermediate range vision woes with multi-focal IOLs
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Continued intermediate range vision woes with multi-focal IOLs
by Mustang Mike, Dec 19, 2006 12:00AM
Brief history & update :
51 years old, working under office fluorescent lighting, on computer. Received bilateral ReStor implants from foremost expert in my area November 2005. Result: 20/20 distant & reading vision, but struggled mightily with poor intermediate vision for 11 months. Explanted (non-dominant) left eye ReStor, replaced with a Rezoom lens, 10/3/06. Reading vision changed (good light worse, low light better) but acceptable, distant still 20/20, intermediate remained poor. Developed PCO, had Yag laser procedure to clear cloudiness in left eye on 11/21/06. Result good clarity, however intermediate vision (i.e. from just beyond arm’s length out 15 – 20 feet) still poor. Problems include seeing the computer, bulletin board behind monitor, papers across desk, items on bookshelf or in a desk drawer, basically everything in the room around you, items on store shelves, etc. Can see well to drive, but the dashboard blurry.
No complications from any procedures, just poor intermediate range vision.
Recently rejected the concept of a laser procedure to permanently enlarge my ~ 2.5mm left pupil to aid the function of the Rezoom lens.
Scheduled 1/11/07 for left eye Lasik to address slight far sightedness (near sight all my life), and residual astigmatism.
What is the probability of success for the Lasik “tweak” to meaningfully improve the intermediate range vision? Is it worth it?
Or, should I accept that this is as good as it gets, and not risk losing some visual acuity in another range (notably reading), while not gaining enough intermediate to
51 years old, working under office fluorescent lighting, on computer. Received bilateral ReStor implants from foremost expert in my area November 2005. Result: 20/20 distant & reading vision, but struggled mightily with poor intermediate vision for 11 months. Explanted (non-dominant) left eye ReStor, replaced with a Rezoom lens, 10/3/06. Reading vision changed (good light worse, low light better) but acceptable, distant still 20/20, intermediate remained poor. Developed PCO, had Yag laser procedure to clear cloudiness in left eye on 11/21/06. Result good clarity, however intermediate vision (i.e. from just beyond arm’s length out 15 – 20 feet) still poor. Problems include seeing the computer, bulletin board behind monitor, papers across desk, items on bookshelf or in a desk drawer, basically everything in the room around you, items on store shelves, etc. Can see well to drive, but the dashboard blurry.
No complications from any procedures, just poor intermediate range vision.
Recently rejected the concept of a laser procedure to permanently enlarge my ~ 2.5mm left pupil to aid the function of the Rezoom lens.
Scheduled 1/11/07 for left eye Lasik to address slight far sightedness (near sight all my life), and residual astigmatism.
What is the probability of success for the Lasik “tweak” to meaningfully improve the intermediate range vision? Is it worth it?
Or, should I accept that this is as good as it gets, and not risk losing some visual acuity in another range (notably reading), while not gaining enough intermediate to
Doctor's Answer
by Forum-OD-MP, Dec 19, 2006 12:00AM
"What is the probability of success for the Lasik “tweak” to meaningfully improve the intermediate range vision? Is it worth it?"
i cant answer that question. no one can. there are no rules and no guidelines and no studies and no "probabilities". is it POSSIBLE? probably. it would depend on many, many factors...your new Rx, your corneal health/thickness, your doc, your doc's equipment, your tolerance to blur/Rx change, etc etc ad naeusem. is it guaranteed? certainly not. these are not easy questions to answer...
i cant answer that question. no one can. there are no rules and no guidelines and no studies and no "probabilities". is it POSSIBLE? probably. it would depend on many, many factors...your new Rx, your corneal health/thickness, your doc, your doc's equipment, your tolerance to blur/Rx change, etc etc ad naeusem. is it guaranteed? certainly not. these are not easy questions to answer...
Last question should end...
Or, should I accept that this is as good as it gets, and not risk losing some visual acuity in another range (notably reading), while not gaining enough intermediate to justify the risk?
Comments, please. Thanks.
Has anyone had a similar experience to mine? Or at least, has anyone had Lasik after implanting multi-focal lenses, to improve one range of vision or another? If so, what was the outcome?
Thanks.
If so, what was the outcome?
Thanks.
I've had Lasik two times in each eye since having ReStor lenses implanted. My intermediate vision was very disappointing after implantation. Previously it was great. Intermediate and distant were actually worse after the first Lasik than before. Since the second Lasik things have have really turned around. 20/20 and 20/30 at last exam a month ago. My intermediate vision has been restored (no pun intended) to pre cataract quality. If you're interested you can read my story, in detail (including aberrations), on this board under a question from "light show" posted 12/01/06.
You have been through it all Tha is my concern---that if I shy away from the risk (of bad results) now and reject the Lasik my doctor is offering me, I may be stopping just short of hte final solution to my intermediate woes. On the other hand, I will kick myself if I end up worse than I am now; i.e. losing some reading or even distant acuity without picking up the intermediate range vision that I sorely lack.
Decisions, decisions. Thanks for sharing your insight.
One thing that I did after having the Rezoom lens implanted was to have my doctor create simulated glasses designed to correct the astigmatism. This was intended to approximate the correction I would get with Lasik. My vision did improve at all distances, but it still was not perfect at close range. For that reason, i decided to have Restor implanted in my other eye. I also understand that small pupil size can undermine the benefits of the Rezoom lens.