Cataract surgery?

Question

I have to get this surgery, i have been to many different specialist and they all say that my optic lense is not shaped right because the connective tissue that hold it in place has torn so in effect caused them to lose their correct shape. So now they say this complicates the surgery because they aren't sure if they have enough connective tissue for the optical lense implants. Has anyone else had this issue and know of what would be the alternative if the connective tissue doesnt hold the implant in place?

Answer 1

That's not that common a condition...
You don't have Marfan's syndrome by any chance?

I've seen a few cases with people with this sort of zonule problem.

Anterior chamber lens implants are available where the new implants cannot be located behind the iris.
These sit just in front of the pupil
They are also used in some cases as an elective technique: an alternative to refractive laser surgery where the RX is very large.
Beyond that there is also the contact lens option before facing the great thick aphakic spectacles which were the norm when I started practising.

One issue to consider:
with the cataract removal you and replacement you will have no accommodation (with damaged zonules, you may not have much now...)
As wel as single vision implants, multifocal lens implants are now being offered, with the potential to eliminate the need for reading or multifocal glasses for close work (assuming your distant vsion is reduced to almost zero by the operation.)

It's an appealing idea, but personally I have my doubts about it. I consider there are at least potential and quite possibly actual drawbacks involving increased glare and loss of contrast.

You will need to research "ReStor, ReZoom Array"
I think the Array lens, at least, is available as an anterior chamber implant, but don't rely on that, check with your own surgeons.

Answer 2

Patti, I had sort of the same experience after I had cataract surgery. The world had gradually become "brown" and dull. I saw the sky as turquoise and the green was avocado. After I had my first eye "done", colors were so vivid, I literally had to put a pillow over my eye to block out things. The sky was intensely BLUE, and grass was a brilliant GREEN. Gradually, it calmed down. Then I got the second eye operated on, and had the same experience. For the first time in my life, I could actually pick out objects in the distance. I had always had extremely poor eyesight, and it was an exhilarating experience. I wore a patch over the operated eye (under my glasses) before I had the second eye done. I couldn't bear the contrast. I will tell you that I have two different kinds of lens implants. The first one left me with a reflection I see at night--sort of a golden haze if light is shining on the lens. The second lens doesn't have that effect. At the time I had my surgeries, they didn't have the bifocal lenses (I think they're called Crystal Lens or something). I've heard they work well in some people, and in others, they have to have them removed or go to using a traditional lens.

Answer 3

The lens sits in a connective tissue "bag". In most cataract surgery, a hole is made in the front of the bag through which the lens is removed. A fake lens is then implanted into the bag. In your case, the "zonules" holding the bag in place may not be stable. They will likely use what's called a capsular tension ring (CTR) during surgery to help hold things in place. In the old days, surgeons would just remove the entire lens, bag and all (intracapsular cataract extraction). In this case, a lens can be attached to a different part of the eye - google 'PCIOL'. Alternatively, glasses or contacts can take over for the lens and bend light if it is not possible to implant a fake lens. Should be OK.