I have a +7.50 in both eyes. What options for surgery do I have?

Question

I have a +7.50 in both eyes , I have worn contact lenses for a number of years without any problems, I would really like to get surgery , as I truly feel unsightly wearing my glasses, having had seve depression for a few years , I feel that I just want to wake up and see like a lot of the population ......what choices do I have ?

David Malitz, MD · Answer

The best option for moderate to extreme hyperopia is a clear lens exchange.  This is certainly the case in patients with cataracts or presbyopia.  It should be noted that this procedure is off label and only a through discussion of the risks and benefits with your surgeon can determine if this procedure is best for you. This procedure, in skilled hands, takes less than 10 minutes, and can achieve distance and near vision.  There are many options regarding lens implants, both accomodative and multifocal.  In farsighted patients, all options tend to work well.  Be prepared for halos with multifocal implants.  With adaptation over time, these tend to be a non-issue, especially with the newer designs.  Naturally, non surgical options are glasses and contact lenses.  Avoid CK, LTK and LASIK or PRK.   Studies show that you may suffer from decreased best corrected visual acuity with hyperopic LASIK (loss of vision).

Cary M. Silverman, MD · Answer

You are beyond LASIK treatment parameters.  Refractive lens exchange (RLE) utilizing femtosecond technology and a multifocal IOL will allow you to wake up, see the alarm clock, drive, and read without glasses.. Permanently! ICL would give you distance vision only and would need to be explanted when you develop cataracts.  Since we are removing your natural lens with RLE, you will never develop cataracts or need to remove the IOL.

Mazin Yaldo, MD · Answer

At +7.50D, your
hyperopia is beyond the range of what can be treated safely with LASIK and
PRK.  If you had laser vision
correction, +4 to +6D could be safely corrected, leaving you with +1.50 to +3.50D
of hyperopia (you would be unhappy, and still need glasses albeit
thinner).  The ICL procedure is
capable of treating high levels of hyperopia and is approved for use outside
the US.  If your eyes are proper
candidates for this procedure, it is an excellent choice.  You may also want to consider a procedure known as RLE or refractive
lens exchange.  This is much like
cataract surgery, where the natural lens of the eye is removed and an
artificial lens implant is placed.  High hyperopia can be corrected with this procedure, with
excellent results.

Martin L. Fox, MD · Answer

This level of hyperopia or far-sightedness is beyond the level treatable with excimer laser technology. This leaves two options for you, hyperopic ICL surgery or clear kens exchange. With ICL surgery an implant lens is placed in the eye. This implantable "contact lens" is available in Europe but will require a comprehensive evaluation to determine its safety for you. The other choice is clear lens exchange surgery. In this scenario the crystalline lens of the eye is removed and replaced with an implant lens in the identical manner cararact surgery is performed. This method has been made even safer with the advent of femtosecond laser technology.

I have a +7.50 in both eyes. What options for surgery do I have?

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