Intraocular lens implants?

[clanalois]

Hi all,

I am a 25 year old female with Sjogren's disease (antibody test and Schirmer's confirmed) for 2 years. Sjogren's eye symptoms are relatively well managed with Restasis twice a day, Dwelle, and Dakrina. Dryness is moderate but manageable and I feel almost normal at times. My opthalmologist has noticed small periphery corneal scarring in both eyes as well as minor neovascularization but these have not changed since I started treatment (no better, no worse) one year ago.

I currently wear glasses with a prescription of about -6.50 OU. I infrequently wear contact lenses (special occasions) and desire permanent vision improvement one day. I know that LASIK or any other corneal-shaping vision correcting surgery is impossible in my condition.

My question to you -- would I be a candidate for ICL or IOL vision correction (Monfocal, ReSTOR, ReZOOM, Crystalens)? As most of you know, this requires a small incision at the periphery of the cornea (something like 2-3mm) and a lens is placed in front of the natural lens. There is no lasering or removal of corneal material. It is almost the same procedure as cataract removal except the natural lens is not removed.

What do you all think? In any case, most of us will get cataracts when we age…can people like us get our cataracts removed?

[Kathel]

Hi,

I would be very careful with any decision to get IOL implants. This is, in fact, cataract surgery without your having cataracts. They do take out your normal lenses. I had this procedure 2 years ago for vision correction, although I did not have cataracts. I have deeply regretted this decision, as the surgery triggered a horrible case of ocular rosacea and dry eye that had been previously subclinical. I know my case is probably unusual, but I learned a lesson about not having unnecessary surgery. And I have had problems with visual aberrations (glare, ghosts, haloes, etc) with my ReSTOR lenses. These multifocal lenses are still fairly new and don't have the bugs worked out yet. I wish I had known that before I had it done. My advice is: don't mess with your eyes if you don't have to, especially if you already have a problem like Sjogren's. Good luck,

Kathel

[clanalois]

Yikes. I'm sorry to hear of your trouble; how are you doing these days?

In any case, thanks for correcting my error regarding lens removal. I read about "Visian ICL" which does not require the lens to be removed. I wonder if this makes any difference.

Anyway, your story is already starting confirm my suspicions - there are no permanent or semi-permanent solution to very poor vision complicated by dry eye. What's more concerning to me is that, because of dry eye, I may never be able to have cataract surgery if/when I develop cataracts at an older (much older) age.

I do like my glasses, though.

Hi,

I would be very careful with any decision to get IOL implants. This is, in fact, cataract surgery without your having cataracts. They do take out your normal lenses. I had this procedure 2 years ago for vision correction, although I did not have cataracts. I have deeply regretted this decision, as the surgery triggered a horrible case of ocular rosacea and dry eye that had been previously subclinical. I know my case is probably unusual, but I learned a lesson about not having unnecessary surgery. And I have had problems with visual aberrations (glare, ghosts, haloes, etc) with my ReSTOR lenses. These multifocal lenses are still fairly new and don't have the bugs worked out yet. I wish I had known that before I had it done. My advice is: don't mess with your eyes if you don't have to, especially if you already have a problem like Sjogren's. Good luck,

Kathel

[Rebecca Petris]

Personally... at such a young age, if you've got Sjogrens, I would avoid any refractive surgery.

I read about "Visian ICL" which does not require the lens to be removed. I wonder if this makes any difference.

The Visian lens is a phakic IOL, implanted in front of the natural lens, as opposed to clear lens exchange procedures like with the STAAR icl. This presents slightly different issues/risks than exchanging the natural lens for an implant. But I don't think any implications for dry eye would vary noticeably amongst the procedures.

[Lucy]

Anyway, your story is already starting confirm my suspicions - there are no permanent or semi-permanent solution to very poor vision complicated by dry eye. What's more concerning to me is that, because of dry eye, I may never be able to have cataract surgery if/when I develop cataracts at an older (much older) age.

Hi, I'm owner of eyes of -9.50 prior to lasik over 7 years ago and left with dry eyes and poor vision. Correctible to only 20/50 now with glasses. I also developed Sjogrens along the way and was diagnosed last year. It really doesn't matter which was first, lasik or Sjogrens, because the result is the same. If I'd not had lasik, I'd still have Sjogrens and probably dry eyes, but my eyes would not be butchered like they are. Plus, I'm about $25,000 in the hole for expenses, travel etc.

I've also had cataract surgery on one eye. I'd not worry about the cataract surgery at your young age. "If" you get cataracts later, (much later :-) ), they could have a whole new way of taking care of them. We are talking probably 30 years or more. So, I'd just take care of the current situation and that means avoiding any refractive surgery. You are lucky to have gotten the word from us (the horses' mouths). Rebecca, I and many others we know were in the first phases of this "wonderful surgery." There was nothing to read about. The doctors acted like we imagined this stuff....Now there is data proving that lasik can cause dry eyes.

Your vision is poor, but at -6.50, you can still get sytlish glasses, especially ones with smaller lens. There are many more styles than there used to be. When large lens were in style in the 80's, I had an awful time trying to look decent. Now, I don't care anymore, just want to have painless eyes.

Lucy

[kimby2007]

Sjogrens

Hi

I am also 25 yrs old with Sjogrens. My markers were negative except from ANA. It is good to hear that you are managing your dry eye relatively well. Unfortunately, I am still in the beginning stages of restasis so I am suffering quite terribly. I also unfortunately have cataracts. I don't need surgery as of yet but will need it some where down the road. Well, it is nice (and not nice) to know there is someone else on this post my age.

[suemom]

What do you all think? In any case, most of us will get cataracts when we age…can peo

Hi - I am 55, have had dry eye syndrome for about 30 years, getting progressively worse as the years go on. I needed cataract surgery on both eyes about three years ago. That was unfortunately due to yet another opthalmologist years ago prescribing a steroid eyedrop (called FML) for my red eyes...she did not mention to me that one of the possible side effects of long term use could be the development of cataracts. (the steroid eyedrop was the only thing that ever helped the redness - (BUT PLEASE STAY AWAY FROM EVER USING STEROID EYE DROPS!)
However, that being said, I can honestly say that my dry red eyes did not change significantly after the surgery for cataracts - they were red and sore before the surgery, and still the same after. The only thing that is helping a bit is the Restasis which I have been on for about two months. I'm passing my cataract experience along for those who are afraid of cataract surgery in the future - it may not make any differenct to your dry red eyes - but will help you to see a lot better when you get to the point of needing the surgery. Sue

[suemom]

Reviewing my last post....

Hi all, I'm new here, and in reviewing my last post, I see that I have not shown the quote correctly....can someone tell me how to add the quote from a previous person's comments at the beginning of my answer? I copied and pasted into the title as you can see, but in looking at it, I see that it is not correct. Thanks Sue

[clanalois]

Hi

I am also 25 yrs old with Sjogrens. My markers were negative except from ANA. It is good to hear that you are managing your dry eye relatively well. Unfortunately, I am still in the beginning stages of restasis so I am suffering quite terribly. I also unfortunately have cataracts. I don't need surgery as of yet but will need it some where down the road. Well, it is nice (and not nice) to know there is someone else on this post my age.

*hugs* I'm also glad (and not glad) to know that you're out there. I had positive markers for SSB, ANA, a high-normal SSA, and high level of anti-RNP (don't know if it's normal for Sjogrens but it's a marker for mixed connective tissue disease, and my marker was high... *sniff*). No Smith antibodies (lupus), thank goodness...

Of course I had an abnormal Schirmer test. We stopped there and I didn't have any biopsies done. I had already been on Restasis for six months via my ophthalmologist before I got the autoantibody tests done for final diagnosis. My other symptoms include moderate and manageable dry mouth. I frequently have swollen gingiva and sore throat, but my teeth seem ok for now.

For some eyedrops, I highly recommend Dwelle and Dakrina, which I just started using. They're fantastic!!! I sometimes feel like my eyes are "normal." I've also been using a cheap eyeshade for sleep, but I think I will get the Tranquil Eyes -- I need something for morning dryness.

However, that being said, I can honestly say that my dry red eyes did not change significantly after the surgery for cataracts - they were red and sore before the surgery, and still the same after. The only thing that is helping a bit is the Restasis which I have been on for about two months. I'm passing my cataract experience along for those who are afraid of cataract surgery in the future - it may not make any differenct to your dry red eyes - but will help you to see a lot better when you get to the point of needing the surgery. Sue

Good to know there's hope, I can't tell you how relieved I feel. It really is a minor surgery to the actual cornea. I've seen many cataract surgeries (I'm a 4th year medical student who has done a ophthalmology surgery rotation). Again, thanks...

Per Lucy and Rebecca's advice, I will stay away from any refractive surgery for the time being...but part of me can't help but wonder if it might be a good idea to get IOLs done sooner than later, when I'm older and my ability to heal is not as effective as it is now.

~Andrea

[kimby2007]

Sjogrens

Thanks Andrea for your post. I also take Evocac (my dry mouth is moderate but the med is also supposed to stimulate tears after a couple of months or so). You may want to consider it down the road although I know the idea of more meds may not be too enticing. Best of luck to you!