Does Lasik affect later cataract surgery like RK surgery does?

[wpcoe]

Found out from Dr Roy at Rutnin Hospital in Bangkok (thanks, Sheryl, for the recommendation) that among other eye issues I have is that when the time comes for cataract surgery, the normally routine surgery can be compromised by the RK (radial keratotomy) surgery I had done on my eyes back in the 1980s.  RK surgery entailed making manual incisions in the cornea to reshape the surface to better focus an image on the retina.

 

He said that because of my RK history, when the time comes for cataract surgery -- and it appears it will come as I currently am at level 1 (out of 5) in development of cataracts -- my recovery period can be a month or more, whereas a non-modified cornea can have a recovery period of as short as a few days.  Furthermore, he said that not as likely, but still a relevant concern, is that the surgery itself can be compromised by an RK-weakened cornea.  Yikes!

 

There's been much talk about Lasik here and I've never heard of such a risk or delay in recovery for cataracts later in life.  Is Lasik sufficiently different from RK in that it does NOT compromise/weaken the cornea and therefore does NOT interfere with cataract surgery and recovery?

 

If I knew someone considering Lasik, I wouldn't want to freak them out if it's a non-issue, but if it is -- or can be -- an issue I think they should be aware.

[Sheryl]

I've looked into this as I had Lasik and also have (still early) cataracts.

 

It does not affect the healing but it complicates the selection of the right artificial lens - they cannot calculate that from current measurements but need to know baseline pre-Lasik corneal measurements, including the calculated corneal power.

 

I would suggest that anyone who has had or gets Lasik be sure to get this information as you never know if a hospital or clinic will still be around and still have your records when the time comes....and sooner or later we almost all get cataracts, the only sure preventive is to die young!

 

And of course the cataract surgery should be done by someone experienced in performing it on Lasik patients. Dr. Roy at Rutnin is.

[wpcoe]

Thanks.  Good to know, and folks who have had Lasik really do need to know that.

 

One scary thing (for me) since I'm  squeamish about my eyes, is that apparently the behavior of an RK-modified cornea can be unpredictable, meaning the doctor can never be sure how things will turn out until after the surgery is done and healed.  The "good news" is that they can re-do the surgery if needed, but that's not something I really want to think about...  

[scubascuba3]

In Thailand they seem to do these ops both eyes at the same time, in the UK its one eye at a time. I think I'd say one eye only in Thailand in case they balls it up

[Sheryl]

Usually do one eye at a time in Thailand in my experience.

It is definitely better to do so and wait until vision in the first eye has stabilized before doing the second. That way, if vision is other than 20/20 in the first eye adjustments can be made in lens selection for the second to balance it out.

More often than not, one eye will require surgery before another does so the issue does not arise -- because cataract surgery should not be done until the cataracts are significantly impairing vision.

It is not unknown for doctors in private hospitals in Thailand to try to persuade people with cataracts to have surgery before it is necessary. I have seen several reports of this and even experienced it myself. So beware. If you have cataracts you will need surgery eventually but there is no rush and if you are not experiencing noticeable visual difficulty with your every day life, it does not yet need surgery.


Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[scubascuba3]

Usually do one eye at a time in Thailand in my experience.

It is definitely better to do so and wait until vision in the first eye has stabilized before doing the second. That way, if vision is other than 20/20 in the first eye adjustments can be made in lens selection for the second to balance it out.

More often than not, one eye will require surgery before another does so the issue does not arise -- because cataract surgery should not be done until the cataracts are significantly impairing vision.

It is not unknown for doctors in private hospitals in Thailand to try to persuade people with cataracts to have surgery before it is necessary. I have seen several reports of this and even experienced it myself. So beware. If you have cataracts you will need surgery eventually but there is no rush and if you are not experiencing noticeable visual difficulty with your every day life, it does not yet need surgery.


Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

The guys i talked to and on previous threads had both eyes done at the same time for those lens replacement Supersight ops, i forget the correct names. Yes different to Cataract where mostly one eye

[Sheryl]

Refractive surgery (Lasik, "supersight" etc.) even more advisable to do one eye at a time. The results cannot be exactly predicted and knowing final result of first eye will inform approach to the second eye. The worst eye should be done first.

There is cost saving to doing both eyes at once which is why many people do that (typically Dr. gives them both options) but it does not provide best chance of optimal result.

When I had Lasik I had the worst eye done first with surgeon aiming for maximum possible correction. I ended up under corrected as he had told me was likely...about -2 (from -13 originally).. Knowing that, surgeon adjusted plan for second eye such that sure to be 20/20 or more as with one eye still myopic, a little obercorrection on 2nd eye was worth risking.


Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app