Hello doctor, I am 49 years old now. I had a cataract surgery in both eyes three years ago. I was told that the formation of cataract was due to side effects of a steroid medicine. When the surgery was done, I did not opt for a progressive lens with cataract lens and power in both the eyes was the same. But, now there is a difference of 0.5 between both the eyes. I am wearing progressive lens with a cylindrical provision. I would like to know whether it is possible to replace my cataract lens with the new one and continue wearing the progressive lens. I have attached my doctor's prescription herewith.
Hello. I have gone through the attachments (attachment removed to protect patient identity). Well, the difference of 0.5 spheres is acceptable in cataract surgery but the problem is the left eye being a plus. Usually, we aim for a postop minus 0.5 in an eye because it will provide some near vision postop. But even with best biometric assessments errors of 0.5 magnitudes occur. It may not be an error because sometimes the lens itself can give rise to a 0.4 error even if your biometry is perfect. Secondly, the right eye cylinder is not due to the power of the lens. Mostly, it is due to the shape of your cornea. Sometimes it may be due to the incision that is necessary for the surgery. Thirdly, the plus lens you need to wear is for the near vision because unlike the natural lens, the artificial one cannot alter its power. The prescription progressive means your specs will be designed to see different distances at different places of specs. Well, there is nothing called a progressive intraocular lens. It is called a multiracial lens. Usually, it is used for young patients because after the age of 40 anyway people lose their ability to see near unless they are myopic. This lens can be used in elderly but for your information, the visual quality is not as good as the normal lenses. Even the best multifocal can accompany patient dissatisfaction and it is very costly. In your case, you can replace the lens for sure. But it is altogether a new surgery. A new cost with an unpredictable outcome. An add-on lens is another option but visual quality with multifocal will be poorer by and large your cataract outcome is favorable and acceptable worldwide. You are sure to have good vision nearly 6/9 without glasses. You will have to use glasses for near. If you wish, you can replace your IOL (intraocular lens). Further, LASIK (laser-assisted in-situ keratomileusis) is also another option for good vision For more information consult an eye care ophthalmologist online -->