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Had LASIK, Have Cataracts….Now What?

February 19, 2012

So, you had your LASIK surgery done many years ago, and have since enjoyed excellent vision without the need of glasses or contacts.  But then, 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?

Cataract Formation

For many, the formation of cataracts is a natural part of the aging process that causes the eyes’ natural lenses to cloud and distort vision. The lens is held inside a capsule, and it 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, and cataract surgery then 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.

Fact Checking LASIK Surgery

Let’s discuss some facts and misconceptions about LASIK surgery so we don’t confuse ourselves later on:

  • 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.

Refractive Surgery As A Choice

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.

For this, we have refractive surgery instead.  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 IOLs (Crystalens) which will 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 its curvature.  These measurements are then used in a complex equation to determine the proper IOL power.  As I previously mentioned, prior LASIK surgery makes these calculations much less accurate.  These calculations can improve if we have access to several measurements from before the initial LASIK surgery.

Keep Track of Your LASIK Records

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 OCLI are in the process of sending all of our previous refractive patients this information to keep for their own 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 when you too might need cataract surgery.

We know that just like us, you want to be able to see clearly.  And yes, its a horrible feeling when cataracts appear even after the LASIK operation has been completed.  That is why it is so incredibly important to not only have a check up by an eye surgeon who specializes in both practices, but to also do all you can to protect your eyes from developing cataracts.  Lucky for you we have multiple tips on how you can prevent cataract development, from quitting smoking to stopping the use of common medication.  Also, be sure to check out our articles on common misconceptions of cataracts in order to keep yourself educated.  Of course, it’s always a good idea to check with your eye surgeon on the effects that certain procedures may have on your eyes, but keep an eye out on our blog for more tips to come on prevention.






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