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Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.
Well, you are -- as they say -- between a rock and a hard place......
Exchanging your Tecnis lens for a monofocal lens will have a very good chance of clearing up your glare issues.....but it will not solve all of your near, intermediate and far focus problems.
Also, you may end up with complications of the exchange surgery and loose the excellent, 20/20, distance vision you have now.
So. What to do?
If you can live with the glare issues and really want more to improve the focus problems then I
I'd get fitted for no line bifocals with plane glass on top (since you see 20/20 in the distance w/o glasses now).
This (costly but risk free) option may give you the different focus points you need to fix the next A/C unit that fails on your watch...
I would not have the lens exchange done until ALL other options are exhausted unless, of course, the halo/glare problem is just something you really can't live with
Does this make sense to you?
The doctors are correct....progressives are very hard to get to work with the intraocular lens you have but, in the last decade, I've got a number of patients good results with them
The power depends on many factors and requires a painstaking trail of lens powers in the fitting room at various distances such as the computer screen, arm length, dashboard length.....
It is a very individualized process to try and work around the (all too common) problem you find yourself in right now.....
You need to find an optometrist who will spend the time and work with you on this.......
Then, if it doesn't work, go ahead with a lens exchange. It can be done even after a yag laser capsulotomy although an anterior vitrectomy may needed at the time of surgery.
In rare cases a retina specialist may have to remove all the vitreous......
It is called healon......works most of the time....I've done it myself :)
Vitreous oozes out all over :) But that is not the end of the world. Every ophthalmologist/cataract surgeon knows how to deal with vitreous....no big deal.
Nothing in medicine -- or life -- is 100%
No. Don't get me wrong. Since you have 20/20 vision you have to accept that, of all the options available to you, lens exchange carries the most risk: Just like your initial surgery -- infection, bleeding, poor result, retinal detachment or swelling, loss of vision, loss of eye...
Trying progressive reading glasses only have the risk of removing money from your bank account and, maybe, causing a small dent on the bridge of your nose...
There is a very, very good chance that an experienced surgeon can exchange your lens safely....but you never know when the lightning bolt will hit.
At this point, the vision you have is the best you can expect for the rest of your life. These issues will not, in my opinion, go away at this point.
Sadly, that is a phrase I hear all too often as a sub-specialist.....
It will not make any difference if you wear them or not.....you can just use them when you need them.....it is not like a pill that you have to take everyday or it doesn't work. Glasses like this can be worn all the time or just when needed per your personal preference.
No. No special training needed. I would think that every optometrist could easily fit you for them.
It means the pilocarpine is making your pupil small so you have pinhole effect and/or are being forced to look through the part of the tecnis focus rings that is set for about 2.5 feet.
That is for the surgeon who examines your eye and plans to do the lens exchange to say.......not me; I just don't have enough data to give a quality answer to that question. I'm sure you understand where I am coming from...
I fully understand.
Endothelial cell count of the front of your eye (cornea) to make sure your cornea can handle the stress of another eye surgery.
Sounds like you are in the hands of a very ethical and well trained eye surgeon.
We have covered a lot of ground here over the last hour. Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?
I cannot see anything that you are typing. Our chat system may not be working well at the moment. I'll switch over to the Q&A system. This system works a lot like 'text messaging' but an email is sent to each of us anytime something is posted to this thread. We can continue to work on your question there..... :)
That is a problem with that lens.........
From what you have posted, I do not feel you will be happy until that tecnis lens is out. It really seems to be bothering you.
I'd talk to that surgeon and 'git 'er done ;)
You seem pretty miserable now.......
The choice can only be made you .....
That is correct.
But, that being said, you have done an excellent job of gathering information to make the best informed choice possible....I wish all my patients were as thoughtful are you ;)
Like a "first" marriage lol!
My pleasure. I wish you the very best. Have a good weekend
I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you can please give me a “10” rating in all areas. It has been a pleasure to assist you today. Thanks in advance, Dr. Rick MD FACS