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Bishoop
medicine forum beginner
Joined: 06 Jun 2006
Posts: 5
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 Posted: Wed Jun 28, 2006 3:13 am Post subject:
Re: Tell me about accomodation after cataract surgery
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<tkopan1@yahoo.com> wrote in message
news:1151458867.188050.116390@d56g2000cwd.googlegroups.com...
| Quote: | Right on both counts. The lenses grow thicker and larger and denser
with time. The newborn has the capacity to focus ~20.00D. By the time
you get to be about 40, the focusing drops to about ~5.00D. When it
drops below that, your arms start getting too short for reading. The
lens gains in size and mass while losing flexibility.
There are several new "focusable" implant lenses availble, Restore
being just one. Placement in the lens sulcus is such that when you
focus, it pushes the lens forward letting you see at near, and when the
muscle relaxes as you look away, the lens moves back for distance...IF
I am thinking of the right lens.
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I believe you are thinking of the wrong lens. I have Restor implants and
they are made of concentric circles with differing capabilities.
Probably a poor description.
| Quote: | Previous posts are correct in that ou should explre all of your
options. It sounds as though yuo are still young enough to focus the
other eye somewhat.
--Dr. Tom
Scott Seidman wrote:
Neil Brooks <neil0502@yahoo.com> wrote in
news:kejl92du9usc7dvi1ppggvujl6326cqg51@4ax.com:
On Thu, 22 Jun 2006 17:02:29 GMT, William Stacy <wstacy@obase.net
wrote:
cerebus wrote:
I'm a 33yo male with
OD -3.75, -2.50 @ 115,
OS -4.00, -1.00 @ 120
which have been like that for over 25 years. I'm accustomed to
wearing glasses or soft contacts full time.
Since mid-March of this year, I rapidly developed a cataract in my
left
eye which is now quite advanced. I've had a consultation for lens
replacement surgery with a well experienced doctor who presented both
IQ
and ReSTOR options for my consideration.
Since I have young, otherwise healthy eyes, I'm uncomfortable with the
prospect of losing the ability to accomodate due to surgery. Is this
a
given (is the ciliary muscle severed during the procedure)?
No, but the artificial lens will have no focusing ability, as it will
be
a rigid lens. Your ciliary muscle will continue to constrict, but it
will have no effect on the iol shape/power (or little or no effect if
it
is a hinged/moveable lens).
So ... Doctor Bill ...
If you said what I think you just said, then you answered my $64,000
question.
The *only* place I found data was in Clyde Oyster's book, "The Human
Eye: Structure and Function" (1999) where he said, in effect, that the
ciliary ennervation never stops in presbyopia; only the accommodation
itself.
Intuitively, even before seeing that, I thought this was right.
Otherwise, something would have to "go dark" and "re-ignite" when
AIOLs were implanted.
My doc *still pushes* for me to get RLE + (preferably monofocal)
IOL's, under the premise that my accommodative mechanism will
eventually give up, thus permanently ending the spasm.
*I* think that--based on my history--giving up is *not in the lexicon
of MY* accommodative system and that putting a brick wall in front of
it will only pi$$ it off ;-)
Do you have any reference for your statement?? Very curious ... and
very interested.
I looked at a 5/05 thread about this and didn't see where you said the
same thing: http://tinyurl.com/nrzuf
TIA,
Neil
There are two current ideas for presbyopia. One, we all have heard of,
is that the lens loses elasticity. The other, which surprised me, is
that the lens grows too big for the cilliary and zonules to be effective.
--
Scott
Reverse name to reply
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William Stacy
medicine forum Guru
Joined: 01 May 2005
Posts: 1177
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| Posted: Wed Jun 28, 2006 5:10 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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Bishoop wrote:
| Quote: | I believe you are thinking of the wrong lens. I have Restor implants and
they are made of concentric circles with differing capabilities.
Probably a poor description.
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Actually a very good description of the lens. How are they doing for you
now? One thing I noticed on the Restor I saw a while back was they
seemed to have pretty strong and unusual reflectance, so they are more
noticeable to people looking at you. Did you notice that?
w.stacy, o.d. |
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Bishoop
medicine forum beginner
Joined: 06 Jun 2006
Posts: 5
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| Posted: Wed Jun 28, 2006 5:50 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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"William Stacy" <wstacy@obase.net> wrote in message
news:YJyog.57210$Lm5.14948@newssvr12.news.prodigy.com...
| Quote: |
Bishoop wrote:
I believe you are thinking of the wrong lens. I have Restor implants and
they are made of concentric circles with differing capabilities.
Probably a poor description.
Actually a very good description of the lens. How are they doing for you
now? One thing I noticed on the Restor I saw a while back was they seemed
to have pretty strong and unusual reflectance, so they are more noticeable
to people looking at you. Did you notice that?
w.stacy, o.d.
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I had the right eye implanted three weeks ago and the left eye last week.
So far noone has commented on them being visible. The only comment has been
how great by blue eyes look! Oh, I also get, where's your glasses from
folks that don't know I've had the implants.
I've looked carefully in a mirror and cannot see them. Maybe with a bright
light behind my head shining into the mirrow would show them. I'll have to
try that.
So far I'm very pleased with the results. I feel that I'm 100% functional
from driving to reading very fine print. That being said I do have a bit of
the problem with the 19" LCD computer montior at three feet. I have the
resolution set to 1280 X 1024. The "optimum" distance for reading is about
14", I wish that was a bit longer.
I am using +1 drug store readers for the monitor and they are workable.
I'll try some different powers and possibly a prescription set just for the
monitor. I can live with that.
The "star bursts" around bright lights is a little annoying but I'm getting
used to it and not having to wear glassses is worth it to me.
I have had no surprises and they live up to the doc's predictions. All
distances are not as sharp as before the implants with good prescription
bi-focals. I was told up front this would be the case.
After 35 years of glasses it's really a pleasure to walk around without the
extra hardware. Of course living in Florida I do wear sunglasses most of
the time I'm partaking of outdoor activities. But then it's nice to walk
into a store and just pick out the sunglasses I like, particularlly for
fishing.
I hope others that have had the Restor lenses installed are as pleased as I
am. |
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William Stacy
medicine forum Guru
Joined: 01 May 2005
Posts: 1177
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| Posted: Wed Jun 28, 2006 6:23 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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Bishoop wrote:
| Quote: | So far I'm very pleased with the results. I feel that I'm 100% functional
from driving to reading very fine print. That being said I do have a bit of
the problem with the 19" LCD computer montior at three feet. I have the
resolution set to 1280 X 1024. The "optimum" distance for reading is about
14", I wish that was a bit longer.
Excactly my thoughts. Why they set the "add" so high is a mystery to me. |
| Quote: | I have had no surprises and they live up to the doc's predictions. All
distances are not as sharp as before the implants with good prescription
bi-focals. I was told up front this would be the case.
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I would expect that to be the case, as some significant optical
compromises have been made.
Glad it worked out for you. |
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Anon E. Muss
medicine forum Guru Wannabe
Joined: 22 May 2006
Posts: 136
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| Posted: Thu Jun 29, 2006 5:16 am Post subject:
Re: Tell me about accomodation after cataract surgery
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On Wed, 28 Jun 2006 13:50:21 -0400, "Bishoop" <none@none.none> wrote:
[snip]
| Quote: | So far I'm very pleased with the results. I feel that I'm 100% functional
from driving to reading very fine print. That being said I do have a bit of
the problem with the 19" LCD computer montior at three feet. I have the
resolution set to 1280 X 1024. The "optimum" distance for reading is about
14", I wish that was a bit longer.
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That is a very commont complaint or comment. If a ReSTOR lens
implantation turns out perfect, people generally get good distance and
good near vision (but that near vision is about what you'd get with a
+3.00D Add)
[snip]
| Quote: | I have had no surprises and they live up to the doc's predictions. All
distances are not as sharp as before the implants with good prescription
bi-focals. I was told up front this would be the case.
|
ReZOOM lenses typically provide better visual acuity than ReSTOR, but
they have their own downsides also. Likewise, with CrystaLens people
typically get better acuity and distance and intermediate, but not
nearly the right up close vision of your ReSTOR. All the current IOLs
have compromises, but they are certainly better than what we had to
offer our patients, even 5 or 10 years ago.
Glad you are enjoying your "new eyes". |
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acemanvx@yahoo.com
medicine forum Guru
Joined: 15 Nov 2005
Posts: 732
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| Posted: Fri Jun 30, 2006 8:32 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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cerebus wrote:
| Quote: | I'm a 33yo male with
OD -3.75, -2.50 @ 115,
OS -4.00, -1.00 @ 120
which have been like that for over 25 years. I'm accustomed to
wearing glasses or soft contacts full time.
Since mid-March of this year, I rapidly developed a cataract in my left
eye which is now quite advanced. I've had a consultation for lens
replacement surgery with a well experienced doctor who presented both IQ
and ReSTOR options for my consideration.
Since I have young, otherwise healthy eyes, I'm uncomfortable with the
prospect of losing the ability to accomodate due to surgery. Is this a
given (is the ciliary muscle severed during the procedure)?
I want to avoid needing bifocals if possible. Does the ReSTOR simply
work as an implanted bifocal, requiring me to tilt up and down to look
out of the proper region? Is correcting the left for excellent
distance vision while keeping the right myopic a good idea? I have also
begun reading about multifocal and accomodative IOCs, but they seem like
they are still in the experimental stage. Would I be better off preserving
my ciliary muscle intact for a few more years until a truly accomodative
solution is perfected, rather than damaging it now and denying that option
in the future?
Any thoughts or insights you can offer are greatly appreciated.
|
It sucks to develop cateract(s) at 33 but the IOLs will not only take
care of that, itll bring you much closer to plano than where you stand
now at -4. What do you use your eyes the most for? If you read for
hours, consider a -2.5d undercorrection. If its surfing the internet,
consider -1.5 to -2d undercorrect. If your life is spent outdoors
seeing distance, you could go for plano but better hope not to get
overcorrected or youll need progressive glasses. I know this lady in
person who ended a bit overcorrected and cant see a thing from near.
Her distance vision isnt bad but still blurry. When I develop
cateracts, Ill choose to be set for near vision, this will keep me out
of readers and protect me from overcorrection. Ill only need a thin
pair of distance glasses occasionally.
"Right on both counts. The lenses grow thicker and larger and denser
with time. The newborn has the capacity to focus ~20.00D. By the time
you get to be about 40, the focusing drops to about ~5.00D. When it
drops below that, your arms start getting too short for reading. The
lens gains in size and mass while losing flexibility."
20 diopters? wow! Thats about 2 inches! You however are wrong, a 40
year old has more like +2 diopters accomodation. He can focus no closer
than half meter clearly. Someone with +5 diopters accomodation can
focus down to 8 inches and ive never seen a 40 year old focus this
close without him being myopic or using a magnifier. |
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Neil Brooks
medicine forum Guru
Joined: 24 Mar 2005
Posts: 1148
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| Posted: Fri Jun 30, 2006 10:03 pm Post subject:
Re: Tell me about accomodation after cataract surgery
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On 30 Jun 2006 13:32:05 -0700, acemanvx@yahoo.com wrote:
| Quote: | 20 diopters? wow! Thats about 2 inches! You however are wrong, a 40
year old has more like +2 diopters accomodation. He can focus no closer
than half meter clearly. Someone with +5 diopters accomodation can
focus down to 8 inches and ive never seen a 40 year old focus this
close without him being myopic or using a magnifier.
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Ace,
How many patients per day ARE you seeing in your practice these days? |
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acemanvx@yahoo.com
medicine forum Guru
Joined: 15 Nov 2005
Posts: 732
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| Posted: Sat Jul 01, 2006 2:46 am Post subject:
Re: Tell me about accomodation after cataract surgery
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Neil Brooks wrote:
| Quote: | On 30 Jun 2006 13:32:05 -0700, acemanvx@yahoo.com wrote:
20 diopters? wow! Thats about 2 inches! You however are wrong, a 40
year old has more like +2 diopters accomodation. He can focus no closer
than half meter clearly. Someone with +5 diopters accomodation can
focus down to 8 inches and ive never seen a 40 year old focus this
close without him being myopic or using a magnifier.
Ace,
How many patients per day ARE you seeing in your practice these days?
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You must have confused me with another doctor, Dr. Brooks. |
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Neil Brooks
medicine forum Guru
Joined: 24 Mar 2005
Posts: 1148
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| Posted: Sat Jul 01, 2006 3:11 am Post subject:
Re: Tell me about accomodation after cataract surgery
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On 30 Jun 2006 19:46:09 -0700, acemanvx@yahoo.com wrote:
| Quote: |
Neil Brooks wrote:
On 30 Jun 2006 13:32:05 -0700, acemanvx@yahoo.com wrote:
20 diopters? wow! Thats about 2 inches! You however are wrong, a 40
year old has more like +2 diopters accomodation. He can focus no closer
than half meter clearly. Someone with +5 diopters accomodation can
focus down to 8 inches and ive never seen a 40 year old focus this
close without him being myopic or using a magnifier.
Ace,
How many patients per day ARE you seeing in your practice these days?
You must have confused me with another doctor, Dr. Brooks.
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No ... I don't think so.
Remember: I'm the guy who always lets people know that I'm NOT a
doctor.
See ... I'm not trying to feed some pathological insecurity by trying
to get respect from Usenet doctors at the risk of harming patients.
That's you ... or Otis.
I try to add what I can, where I can, always prefacing it with "I'm
not a doctor, but..."
I thought I'd clued you in on that before. No? Hm. |
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acemanvx@yahoo.com
medicine forum Guru
Joined: 15 Nov 2005
Posts: 732
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| Posted: Sat Jul 01, 2006 5:07 am Post subject:
Re: Tell me about accomodation after cataract surgery
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Neil Brooks wrote:
| Quote: | On 30 Jun 2006 19:46:09 -0700, acemanvx@yahoo.com wrote:
Neil Brooks wrote:
On 30 Jun 2006 13:32:05 -0700, acemanvx@yahoo.com wrote:
20 diopters? wow! Thats about 2 inches! You however are wrong, a 40
year old has more like +2 diopters accomodation. He can focus no closer
than half meter clearly. Someone with +5 diopters accomodation can
focus down to 8 inches and ive never seen a 40 year old focus this
close without him being myopic or using a magnifier.
Ace,
How many patients per day ARE you seeing in your practice these days?
You must have confused me with another doctor, Dr. Brooks.
No ... I don't think so.
Remember: I'm the guy who always lets people know that I'm NOT a
doctor.
See ... I'm not trying to feed some pathological insecurity by trying
to get respect from Usenet doctors at the risk of harming patients.
That's you ... or Otis.
I try to add what I can, where I can, always prefacing it with "I'm
not a doctor, but..."
I thought I'd clued you in on that before. No? Hm.
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Arent you an optometrist in real life? I thought I heard somewhere that
you were and is why you know so much about vision  |
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serebel
medicine forum addict
Joined: 12 Aug 2005
Posts: 81
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| Posted: Sun Jul 02, 2006 2:44 am Post subject:
Re: Tell me about accomodation after cataract surgery
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acemanvx@yahoo.com wrote:
| Quote: |
Arent you an optometrist in real life? I thought I heard somewhere that
you were and is why you know so much about vision
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Ace, aren't you a retard in real life ? |
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