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Jeffrey Martin MD,
North Shore Eye Care

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Cataract Surgery After LASIK

By Jeffrey Martin, MD

Published on March 31, 2010

Laser vision correction has been a popular outpatient eye surgery over the past ten years. Many patients have enjoyed the benefit of life without glasses and contact lenses and the results have never been better. With current technology, we are able to perform bladeless custom LASIK or iLASIK, which Dr. Jeffrey Martin feels is the very best way to have LASIK laser eye surgery. With Intralase, a blade free laser, we make the most precise and safest flap possible in the superficial layers of the cornea. We then use the CustomVue LASIK system to make the refractive correction. With CustomVue, we get a Waveprint or Wavemap of your individual eye, which is like a fingerprint of your vision. This custom correction is then placed on the cornea using iris registration for exact centering as well as automatic tracking during the LASIK laser vision correction. This has been an amazing advancement in ophthalmology and eye surgery.

As our LASIK patients become older, the natural lens of the eye will begin to be cloudy like all other people. This natural clouding of the lens of the eye is called a cataract. Cataract is the aging of the lens and when the cataract or defective lens is significant enough to impair vision to a level that affects quality of life, cataract surgeons will suggest cataract surgery. Cataract surgery is also an ultra-modern procedure and most cases do not require use of needles around the eyes, stitches, or even an eye patch. The cataract surgery takes a few minutes and is completed through a small incision using gentle computer controlled ultrasound called phacoemulsification. After the defective lens is removed, we place an intraocular lens or IOL of predetermined power into the eye where the original lens was in the lens capsule. The measurements to determine lens power are very sophisticated and are quite accurate. However, after LASIK, the corneal measurements that are used in all of the lens implant formulas have been altered due to reshaping of the cornea and this now needs to be taken into account.

With practice and attention to detail, cataract surgeons are able to estimate the changes caused by LASIK quite accurately using the historical information. There are also several formulas that are designed for the post- LASIK eye. It is important that every patient that has had laser vision correction lets the cataract surgeon know that they have had laser eye surgery. Dr. Jeffrey Martin feels that using the historical method has been successful in his practice having used it in hundreds of cataract cases.

If the implant measurements are not perfect, it may be necessary to perform a laser vision correction enhancement to achieve the final refractive result. In some practices, about 10 percent of patients that have had previous LASIK will need a laser vision correction touch-up following cataract surgery for the best visual result.

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Keyword Tags: lasik, cataracts

Comments

1

Historical data are required, as the corneal topography have been significantly changed by the last lasik surgery. The typical algorithm used for IOL calculations are based on a uniform corneal topography, which is based on the resulting refractive errors calculated via conventional refractography. Once the corneal has been reshaped with lasik, the whol refractive equation has been skewed, hence the IOL formula will have to take this into account. Accuracy for non-lasik eyes is already quite difficult, much more so with compounding variations caused by the lasik alterated topography. Therefore, it is imperative that you keep a detailed record of your lasik surrgeries, so that future surgeons doing your cataract surgery will have more data to work with, for a more reliable outcome.

Dr. James McLea
about 1 year ago

2

my comment is in reference to comment left by JB. I too had cataract surgery on both eyes 8 mos ago. I have experienced almost identical problems that JB had. I have been to 5 new specialists total 7 including the opthamologist and optometrist i went to in the first place who ruined my vision. I had 20/25 vision before surgery and feel that the surgery was not necessary for me. This i discovered only after getting my records and seeing new professionals. I feel that with the only set of eyes given to me the surgeon was looking only for money and then didnt want to hear about my post surgery problems. He eve had the nerve to tell me that I could see well enough to land a jet on an aircraft carrier! I should be able to trade eyes with him! The arrogance~! Now im faced with having to have yag to remove clouds in my eyes. I will be writing him up to the Va Bf of Medicine. my question is what is the percentage of risk involved in this new surgery i may consider doing and my advice to everyone is if you only have the beginnings of cataracts have at lkeast 4 other professional opinions before you let anyone touch your eyes!

judy
almost 2 years ago

3

I had a cataract surgery 10 days ago. My eye is swollen, red and very sensetive to the light. My doctor says I am elergic to the eye drops used post surgery. I tried diff ones, but nothing changed. I wake up in the morning unable to open my eye. The pain is so sharp I have to keep my eye covered for most of the day, and my vision is very blurry. What option do I have to the traditional eye drops? Are there any without preservatives or irritating chemicals?

Dalia Cherazie
about 2 years ago

4

I'm unclear why historical information is required, isn't the new shape of the eye unchanged by the cataract surgery? Wouldn't the lens inplanted have to work with the post laser measurements, not the prelaser measurements?

frank Freitas
about 2 years ago

5

I had Lasik mono vision surgery 11 years ago, and recently had was diagnosed with cataract, therefore, I chose the HD Crystal Lyns when doing the cataract surgery, which did well until the Dr. chose to do "Yag" surgery (puts a hole in the back of the lens pocket to allow more light in around lens), which totally destroyed the clarity of the success of the initial cataract surgery. Even though I can read and see distance (not clear distance vision), after the "Yag" surgery I now suffer with a smokey haze and many gloaters in front of my vision. I have explained all this to Dr. who did the surgery, however, he doesn't "get it" - he tries to make me think this is all in my head, which is very insulting. He says he has never heard anyone describe such difficulty with clarity in vision. However, in doing research, I have found there are several negative issues which one may experience after "Yag" surgery & one is damage to the lens, which I feel is what I'm dealing with (when I look right to left vs. - the fog & trash follows my vision - similar to a filthy contact), as I had no problems until the "yag" surgery was done, which the doctor was paid $18,000 by my insurance company for the "Yag" procedure. My question now is, do doctors recommend the "Yag" surgery after cataract in order to make the extra money. If I had it to do over, no doctor would be allowed to do a "Yag" procedure to my eyes and no doctor would be allowed to implant HD Crystal Lens in my eyes. My friend has had the "Medicare" lens (cheaper lenses) implanted (mono vision prescription - one for distance & one for close up) when having cataract surgery and she has clear and great vision. In fact her doctor stated, most likely, I am suffering from damaged lens due to the "Yag" surgery. I do plan to pursue more clarification, with other doctors, to see what needs to be done to clear the fog and hazing in front of my eyes. I have no outdoors vision which is clear (day) & am not able to read street signs unless about 15ft from sign. However, at night, I can see all signs. This is due to the fact the "Yag" allowed too much light into my eyes and with too much light, one has a terrible glare in daylight. However, doctor will not take any ownership. I paid $5200 dollars extra for the HD Crystal Lens vs. the insurance paying 100% of the Medicare lenses, which was great in the beginning, however, the doctor couldn't leave well enough alone, and do a Lasik enhancement for my distance eye, which he finally had to do anyway. He pushed forward to get the extra $1800 dollars. Be ware when a doctor mentions "Yag" surgery (run as far as you can run from that doctor), and I would not recommend HD Crystal Lenses to anyone.

JB
over 2 years ago

6

I had lasik done for me in 1998 for myopia now the left eye is
-14 the right -5.5 with cataract in both eyes. phaco is planned for my lft eye . Can I expect to get rid of my glasses.

Mohammad Suhail
over 2 years ago







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