Cataract, astigmatism, toric IOL, glasses and IOL selection

[@iol-adviser]

👉 Uncover IOL truth at IOL-adviser.com 👈 👉 Check AI IOL assistant at www.iol-adviser.com/ai-mvp 👈

[@juicer52]

Well, the first surgeon I saw said he doesn't use or feel the need for laser. Turns out, he also failed to detect that I had something called an epiretinal membrane in one eye. According to the literature, even if minimal, it is a definite no no for multifocal lenses which his office had dates scheduled me for placement until I chickened out for other reasons. My reason for changing course to enhanced monofocals was that getting multifocals with greater likelihood of night time glare, halos and decreased contrast would fail to address my chief complaint of poor vision while driving at night. The undiagnosed epiretinal membrane issue raised doubt as to proper initial treatment planning. The second surgeon is suggesting J&J Eyhance enhanced monofocal IOL implants in both eyes and laser corneal reshaping of the minimal (-0.50 or -0.75) regular astigmatism in each eye. I have an appointment for a laser scan tomorrow and will report back. Sites like this one hosted by Oleksii are of great benefit in discussing the latest updates and many options in cataract surgery in ways that a layperson can understand.

[@ludmilav3907]

Thank you so much for all of your videos about IOLs selection. I am in a process of watching all of them, getting ready for the pre-cataract surgery consultation in the end of September.

[@iol-adviser]

thank you for your support. I hope your surgery went well! :)

[@ckp2ator389]

Thanks for this video and others. There are so many things that go into good vision that the lay person has not considered until cataract surgery. There is no one roadmap for achieving good vision, as lifestyle, age, tradeoffs in the choices, should all be considered. An example of monofocal toric lens not extending depth of focus was my neighbor who had cataract surgery recently. He chose distance as his target. He uses two pairs of readers, +3 (for close work) and +1.5 (for computer) for closer distances. The toric lens in one astigmatic eye enables image clarity.

[@iol-adviser]

thank you for your comment. that's why I launched my AI powered IOL selection assistant, which is using my instruction and set of knowledge to help

[@CC-uh8gl]

@ckp2ator389 why not just get progressives for intermediate and near vision?

[@ckp2ator389]

@@CC-uh8gl He never could get used to wearing progressives so instead had two pairs of bifocals (before cataracts). One was computer/reading and the other distance/reading. Now he doesn’t need any distance correction, so just uses readers.

[@111msw]

Really good information....Thank you 👍

[@robertfong-mow7235]

Can you do a video on possible problems with toric iol implants and how they are addressed? Thanks.

[@juicer52]

Can computer guided laser "enhancement" (limbal incisions?) at the time of a standard Eyhance IOL placement for cataracts neutralize 1.5 D corneal astigmatism or is it better treated with a toric lens or a combination of both? What is considered most predictable in neutralizing this amount of astigmatism?

[@juicer52]

I have +6.25 hyperopia with mild astigmatism in both eyes. -.75 and -.50. The astigmatism is described as "regular." If cost is no object, can laser cataract surgery also be used to recontour the cornea (through a releasing incision?) and would it be preferable over a toric lens implant to correct the mild astigmatism? I am considering Eyhance in both eyes. Your videos are clear and concise. Thank you for your guidance in this complicated field.

[@ckp2ator389]

What does your surgeon say? The first ophthalmologist that I consulted wanted to do the relaxing incision on one eye due to mild astigmatism (currently my prescription has -1 cyl in both eyes). He never even mentioned the possibility of a toric lens. I don't know if one solution is preferable over another. I have read that it's very important to get the toric lens placed in the right position. I'm hoping any astigmatism I have can be corrected post-surgery with glasses, as I see myself wearing glasses most of the time anyway.

[@juicer52]

@@ckp2ator389 Well, the first surgeon I saw said he doesn't use or feel the need for laser. Turns out, he also failed to detect that I had something called an epiretinal membrane in one eye. According to the literature, even if minimal, it is a definite no no for multifocal lenses while his office had dates scheduled me for placement until I chickened out for other reasons. My reason for changing course to enhanced monofocals was that getting multifocals with greater likelihood of night time glare, halos and decreased contrast would fail to address my chief complaint of poor vision while driving at night. The undiagnosed epiretinal membrane issue raised doubt as to proper initial treatment planning. The second surgeon is suggesting J&J Eyhance enhanced monofocal IOL implants in both eyes and laser corneal reshaping of the minimal (-0.50 or -0.75) regular astigmatism in each eye. I have an appointment for a laser scan tomorrow and will report back. Sites like this one hosted by Oleksii are of great benefit in discussing the latest updates in cataract surgery in ways that a layperson can understand.