A history of medical or ocular conditions does not necessarily mean patients can’t enjoy excellent vision. Dr. Davidorf recently performed cataract surgery, implanting a multifocal intraocular lens, for a female patient with a history of diabetic retinopathy in both eyes. Prior to seeing Dr. Davidorf, the patient also had cataract surgery on her right eye. She came to Davidorf Eye Group complaining of decreased vision in both eyes. Dr. Davidorf found that she had developed a visually significant cataract in her left eye, along with some astigmatism, and had a moderate amount of astigmatism in her previously treated right eye. The patient’s retinas showed no signs of new diabetic retinopathy and her blood sugar levels were under control.
The patient clearly needed cataract surgery but also wanted to decrease her dependency on glasses. Typically, ideal candidates for the more advanced refractive surgeries, including LASIK and multifocal intraocular lenses, (which can allow cataract patients independence of glasses) do not have extensive ocular or medical histories. Fortunately, these histories are not necessarily a contraindication to improved vision. Despite her history of diabetic retinopathy, astigmatism, and prior cataract surgery with a standard lens implanted in one eye, this patient was able to achieve an excellent visual outcome with the ReSTOR multifocal lens implant. This lens provides good functional vision, without glasses, for most activities.
“Typically, optimal results with multifocal lenses such as the ReSTOR and TECNIS lenses are achieved when patients have the lenses implanted in both eyes,” observed Dr. Davidorf.”However, patients can still be good candidates, and reduce their dependence on glasses, with a multifocal lens implanted in their second eye”.
The last item requiring attention was the astigmatism in her previously treated right eye. Despite the fact that she had prior cataract surgery, she was an excellent candidate for LASIK. Additionally, the history of well-treated diabetic retinopathy did not contraindicate LASIK.
ReSTOR patients achieve the best vision when their astigmatism is minimized. Dr. Davidorf’s plan was to correct any residual astigmatism with LASIK, once her left eye stabilized following the ReSTOR implant. The patient saw quite well within the first couple of days following the RESTOR surgery. As expected, a small amount of residual astigmatism was present. Since Dr. Davidorf was already planning on performing LASIK in her previously treated (cataract surgery) right eye (the eye with a substantial amount of astigmatism), he was able to perform LASIK on both eyes on the same day.
“The patient has done exceptionally well following the procedures and is able to perform all of her tasks and activities without glasses,” Dr. Davidorf stated.”As importantly, her eyes remain healthy and display no reactivation of diabetic retinopathy. This should continue as long as the blood sugar levels and blood pressure remain well controlled. We’re both very happy with her visual outcome.”
