Cataract Surgery for RK "Victim"

Thank you! I've been hyperopic for years, and I don't really care about that deficit because I can actually wear drugstore reading glasses to see to drive while using another pair to read. I also
have progressive lenses if I don't want to do the perpetual switching. My right eye can be corrected with any of these glasses; it's the left eye that's degraded. What I don't want as a result of cataract surgery is myopia, the reason I underwent RK to begin with. This particular ophthalmologist wants to use the light adjustable lenses and aim for myopia instead of hyperopia, and I don't want that objective. So, we have a conflict. I would rather be hyperopic than myopic, as I've lived with hyperopia for years. And, indeed, it is peculiar that I use reading glasses to see distances.

Because I have a Medicare Advantage plan, I can't go out of network unless I want to pay a fortune. I don't, as I already will be paying out of pocket for the LAL, if I even decide to go that lens route.

I appreciate your response, and I'm going to keep doing research until I'm satisfied that I've made the right choice of surgeon and lens choice. I'll keep you posted!

glad to see your comments and your positive results. I also had RK many years go thinking it was wonderful until!
Now needing cataract surgery in Birmingham, AL searching for surgeon
competent in cataract procedure on RK eyes. Very uneasy to have procedure

wry,

There is an LAL fb group (https://www.facebook.com/groups/1796403137542913) - lots of info. An ophthalmologic surgeon is the admin and there are a couple other surgeons on, as well) - he recommends:
1 ensure no dry eye or other pathologies in play prior to work ups ( dry eye can take up to several months to treat - a solid refraction is essential)
2 go to an experienced LAL surgeon
3 chose the right IOL to get to 0.50 hyperopic so the first adjustment can be myopic which gets 0.50 of EDOF
4 if choosing mono/blended vision wear a trial contact to determine script you are happiest with and adjust myopically to there
Note - he does NOT recommend choosing IOL script to match your end state target.

RK is a more challenging circumstance and outcomes vary, but my understanding is that RK, to an even greater extent than PRK or LASIK, presents a lot of unknowns relative to the data models that are used for virgin corneas.

Edit - my end state with LAL (not LAL+) is dom eye 20/15 (close to plano), non dom is J1+ near and 20/25 distance (-2.00 with a bit of cylinder). I had PRK 18 years ago.

I would like more information on your surgery. I also have cataracts
and had RK back in early 1990s. I am now afraid to have cataract surgery
afraid I will lose vision instead of gaining.
I have found one MD with local Medical Center who is confident
willing to perform cataract surgery on my eyes but so afraid
lens selection is iffy as this seems to be one or main issue with cataract
surgery on us RK folks

Hello. Would you like a short answer or a detailed one? If you want the latter, you'll need to give me a day or two.

sjh,

Did you see my note re LAL and its applicability for previous refractive surgery patients, above?

Good luck, sjh1947, with obtaining stable visual acuity after cataract surgery with your rk status. I deal with tired eyes, dysphotopsia, and wearing various plus prescriptions throughout the day for everything. My surgeries took place on May 15 and May 29. I am obtaining a second opinion as to my results, as I will never return to VA Eye Institute.

I did not go for LAL because I discovered that I was not a safe candidate after my own research. The monofocals were inserted, and I do not trust the accuracy of the lenses power calculations.

Essentially, my fluctuating vision pre-cataract surgery still exists. I can see to drive well enough without glasses -- not 20/20, though -- but I haven't attempted to drive at night.

I'm still glad that I had the surgery because colors are brighter, but I wish I had gone to Wilmer or Wills or Stein or Bascom Palmer -- in an alternate reality -- where I bet I would be thrilled with the results.

Again, good luck.

I had RK in 1987....16 cuts in each eye....so far I can pass my DL ....but I am worried about cataracts, they are there just not bad enough yet. I too wear over the counter reading glasses as they work better than any prescription ones for reading. Must be something to do with RK

my first 8 cuts didn't give me good vision so he went in and did 8 more. 16 cuts is a lot and being over 80 I worry about my eye future as there are few doctors who can do rk and cataracts or just say they can do them and once they screw up your eyes they will just say it's your RK or whatever....
I've always been an egg eater so don't know if that is the reason my cataracts have stayed kind of stable. Don't think the ophthalmologists do either. Made a big mistake by getting RK. But so far I'm lucky considering...
.I also have Sjogren's Syndrome... nothing to do with the RK surgery. .I've had all my tear ducts lasered shut...gave me my life back as I was using ointment every hour. Now I don't have to use anything. But doctors rarely mention this procedure and it's painless and only takes a few minutes. I lucked out by getting a knowledgeable doctor....Unfortunately he has passed away.

I've had one of the best Bay Area ophthalmologists tell me my corneas were slowly collapsing....like the top of a barn......slowly caving in....not true but scared the he-- out of me. I went to the Mayo Clinic and the dr there said it was completely untrue. So will hold on as long as possible. I'm in Calif.