Is LASIK for Astigmatism Safe after Cataract Surgery?

Cataract surgery is a well known and popular procedure for older patients who suffer from vision loss after cataracts. Those familiar with LASIK surgery know that it is possible to have cataracts after LASIK. What some don’t know is if LASIK is possible after cataract surgery Las Vegas eye doctors say that it is possible.

LASIK after Cataract Surgery to correct astigmatism is an option for those people who have residual astigmatism after their Cataract operation. Your current prescription indicates that you have preexisting astigmatism along with presbyopia-a common condition whereby the crystalline lens loses its ability to change focus causing you to have difficulty with near vision. It is possible to have a monofocal lens implant and NOT correct the preexisting astigmatism which would probably necessitate either wearing glasses or a second surgery-either LASIK Surgery or Limbal Relaxing Incisions (LRI) in order to see clearly at distance. A possible better solution might be to have a toric lens implant that would correct your astigmatism as part of the Cataract removal all in one procedure. However the decision to have a toric lens implant is based on several factors in addition to the prescription. If you are a good candidate for an astigmatism correcting lens implant (IOL) and you would not typically elect NOT to have one so as to require a second surgery such as LASIK. The best next step for you is to find a local Las Vegas Cataract Surgeon who is also a top Las Vegas LASIK Surgeon who will provide an examination that includes some additional measurements including evaluation of the shape of your cornea and help you determine what the best options might be for you.

Astigmatism and Toric IOL’s: Astigmatism is a very common imperfection of the eye and is present when the cornea is not spherical like a basketball. An asymmetrically curved object, such as a football, is said to have a “toric” shape. When a cornea (the front curved surface of the eye) is toric, light rays passing through it do not focus to a single point. The result is “astigmatism” (Greek: not to a point). Glasses and contacts can be made in toric shapes to compensate for the imperfect curvature of the cornea. Likewise, a toric IOL can be implanted instead of spherical one to neutralize astigmatism of the cornea, thereby providing better focusing without glasses than spherical IOLs. In this way, astigmatism can be reduced or eliminated at the time of cataract surgery. If you have a significant degree of astigmatism, this IOL option may be discussed with you.

The use of a toric IOL necessitates additional specific measurements, planning, surgical execution and post-operative considerations not required when implanting traditional spherical IOLs. As Medicare and most other insurance companies do not provide payment for the surgical correction of astigmatism, patients are responsible for payment of these non-covered services. Toric IOLs, like toric eyeglasses, must be oriented correctly within the optical system of the eye to improve astigmatism maximally. It is possible, although unlikely, that a toric IOL may shift in position during the first few weeks following implantation, since it takes some time for the tissue inside the eye to firmly affix an IOL in position. In the case of significant IOL shift and reduction in vision, a second brief procedure to reposition the IOL may be necessary a few weeks after implantation.

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Vision Correction Options in Las Vegas

LASIK (Laser In-Situ Keratomileusis)
In Las Vegas LASIK is the most advanced refractive surgical procedure available today and can correct low to severe degrees of myopia and astigmatism and moderate degrees of hyperopia (farsightedness). It also requires a higher degree of skill and experience on behalf of the surgeon.

Clear Lens Extraction
Clear Lens Extraction involves removing the internal lens of the eye, just like in a typical Las Vegas cataract surgery. This is done with a special ultrasound instrument and may be done with eye-drop anesthesia (similar to LASIK). The procedure can be performed without the need for stitches. A flexible synthetic lens implant of the proper power is then placed inside the eye through an extremely small incision to correct the refractive error.

This procedure is more commonly performed for treating higher levels of farsightedness in patients over age forty. The optical results are excellent and the visual recovery period is brief. Clear Lens Extraction may also be used to correct higher levels of nearsightedness and may be fine tuned with LASIK if a small refractive error remains. Your doctor may discuss this procedure with you if you are not a candidate for PRK or LASIK.

PRK (Photorefractive Keratectomy)
Photorefractive Keratectomy is performed to correct mild to moderate degrees of myopia and astigmatism, and requires no incisions. With PRK, the surgeon uses the computer-assisted Excimer Laser to flatten the cornea by removing a layer approximately the thickness of a human hair. There is no pain during the procedure, as anesthetic eye drops insure maximum comfort.

The laser is a cool, non-thermal form of light energy that does not burn or damage the delicate tissue surrounding the treated area. The surface of the eye heals within three days, during which time a protective contact lens is worn.

The eye is anesthetized with eye drops. Rather than removing the corneal surface layers as described for PRK, a precision instrument called a “microkeratome” is used to create a thin flap of corneal tissue that remains attached to the eye in a hinge-like fashion. After the Excimer laser sculpts the deeper corneal layers, the flap is replaced to its original position. In this way, the healing time needed for the surface cells to regenerate is eliminated and post-operative comfort is maximized.

Wavefront – Guided LASIK
Wavefront-guided LASIK is a variation of LASIK surgery in Las Vegas where, rather than applying a simple correction of focusing power to the cornea (as in traditional LASIK), our surgeon applies a spatially varying correction, guiding the computer controlled excimer laser with measurements from the wavefront sensor. The goal is to achieve a more optically perfect eye, however, the final outcome of this technology depends on the success of the surgeon in predicting changes which will occur during healing. Las Vegas LASIK surgeon, Dr. Hiss, has successfully calculated thousands of LASIK outcomes using the Wavefront-guided technology with lowered incidence of “halos” and higher patient satisfaction.

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