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Eye & Vision Message Board


Eye & Vision Board Index


[QUOTE=xx1944;5130278]VITct I meant what model IOL did you have??? Like Alcon,Abbott,BL,Staar...???? and the model
name..[/QUOTE]

xx1944: Intrigued by your question, I asked my cataract clinic (PCLI, Bellevue, WA) about my IOLs (however, my cat. sx was 11 years ago, and may be superceded by better technology now) - Manufacturer: Chiron/LoLab/I.O. (now bought by Bausch & Lomb), Single-Focal Length, Model 80958, Different powers in both eyes, but same optics and lengths. I got back 20/20 after the cataract surgeries for distance vision and have been very happy with them, although, I have to use reading glasses, of course. The IOL specs are very much dependent on how accurately the dr measures your eye, and, I understand, there is a "surgeon factor" in the specs. of IOLs!

I read on the web that now they have multi-focal IOLs and even for astigmatism (toric) but each has its own pros and cons, so you have to be careful in what you get. There are also mono-focal lenses with distance vision in one eye and near-vision in the other. Sometimes, I think, although we feel like we know a lot from the web, we don't know, as patients, the interpretation of the results of clinical trials, the long-term risks, the real scientific details, etc. Isn't it in your best interest, to let your surgeon select the manufacturer and the model, once you let him/her know your choice for what sort of vision you want - I mean, single vs multi focal, want to let blue light in or not, etc.?

IOLs also can sometimes cause secondary cataracts, as happened with my right eye, but not the left one. But that is easily correctable with a few-minutes of Nd:YAG laser treatment. However, note that all of this also increases the chances of retinal detachment.
tubint:
As you suggested, I have asked my dr's clinic to send my OCT scans, and they are going to send them as CD's rather than e-copies because, I guess, the files may be too long. My dr had shown them to me pre- and post-op on his computer screen and did actually discuss with me some of the features - like, showing where the wrinkling was with the ERM on the right eye, or none on the left and that it was flattening on to its base RPE properly with no fluid behind it after the vit. sx., etc. I guess, for the right eye, which showed ERM, since it was asymptomatic (that is, it showed no vision problems: 20/20, no waviness/wiggliness on Amsler grid, etc.), I am gusessing, he considered it as a non-issue, at this stage, and did not tell me any retinal thickness metrics, etc. It turns out that actually he does answer a whole bunch of questions I have, and spends reasonable time with me on that, but I did not think of asking him more about ERM then. By the way, these are all black 'n white OCT scans, although I have seen some on the web which are colored - most likely after some sort of dye injection which separates the different layers in the retina.
After you talked about your "delay in focus" issue and "IS/OS junction" problems, I found a bunch about the second topic on the web, but not much on the first. The focus delay must be really strange, although you say your corrected visual acuity is pretty good. I hope it will improve with time, but this IO/OS stuff is pretty delicate and goes far beyond just retinal detachment (has it anything to do what others have called "missing pixels?"). I used to think that retinal tear, macular RD and vitrectomy is bad enough, now I am slowly learning through this thread and others on HB that there can be far stranger and more complicated issues with the retina, structural & neuro-adaptive - with or without RD.
In trying to get to the root cause of my visual distortion issues after the macular RD repair, I have learned a couple of things from the web which may, perhaps, help others in giving some sort of closure to their problems (perhaps, not):
The change in image size, sometimes called as micropsia/macropsia, can come from the "change in distance between the cones in the fovea." The cones, which give us visual acuity and color perception, are very small photoreceptors (0.0004 mm to 0.004 mm) and bunched really tightly in the fovea (175,000 per square mm) and face the RPE base. So, when cryopexy is done for the macula/fovea during the retinal repair, these cone cells can get displaced somewhat, perhaps, even destroyed (as my dr told me). Thus, their pixel addresses in the brain are not only changed but, sometimes, just wiped out, and the brain re-groups info from the neighboring cells and re-learns, but that takes time! So, certain neuro-adaptive visual exercises may, perhaps, help accelerate that healing process.
Similarly, I am trying to find the physiological root-cause of the waviness/wiggliness in my vision. Not that knowing it will improve my vision, but, I guess, that's just my way of coping with the visual limitations I may have later. I know it has something to do with the "edge-detection" algorithm that our brain (visual cortex) utilizes, but that's that. And, in reality, I am worried if that will ever go away in my case, although the visual acuity may get slightly better (e.g., the left eye is already seeing better at certain "intermediate" distances than my dominant eye, like, the dashboard, but the wiggliness at microscale remains!).
tubint: Yeah, once these eye troubles (cat+RD+cat/vit sx) started happening to me I have been reading voraciously about them with whatever I can get my hands on - via internet, as well as, sometimes medical books in the local university, library or book-store...of course, with whatever eye is functionally working at that time :). Although it satisfies my curiosity about these things (and the medical research on retina, in particular, is truly a fascinating field), my real reasons are (a) Is my vision going to improve at all in the near or distant future? (b) What are the options to improve it, and how can I implement them? and, (c) What are the root-causes for my particular trouble? Hunting for the best surgeon and clinic is a different issue though, where, "HealthGrades" is a good web-site. But, finally, no matter how much we think we know about a particular eye problem, we need to rely on professionals (surgeons, and optometrists in the end) to take care of it. And, once you yourself go through these eye-opening surgeries (literally) and get your vision back, completely or somewhat, you truly start admiring these skillful eye surgeons, and the medical profession, in general. And, when it doesn't improve, it's a wholly different story...(Btw I didn't know what CME was, but wiki has a lot of stuff on it, and I am sure you have already read a bunch on it.)





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