Meet the patient
Mr G is a 72-year-old gentleman who had previously undergone laser eye surgery to correct his short-sightedness (myopia). Several years later, he developed cataracts and came to iLase to see me for treatment.
| Myopia: Myopia, or short-sightedness, means that distant objects appear blurred. It can be corrected with glasses, contact lenses or certain types of eye surgery. |
What had happened?
> 2021
In 2021, Mr G developed a cataract in his right eye and had cataract surgery at a St Elsewhere hospital. Unfortunately, things didn’t work out quite as expected and he was left with a prescription of -2.25D. This meant that without his glasses he could only see the largest top letters on the eye chart.
> 2025
Four years later he came to see me about his left eye, which had also developed a cataract. The results of his surgery were excellent – he achieved 6/6 vision for distance with almost no glasses prescription. Together we chose an EDOF lens, which meant he could see well enough at closer distances to read without glasses.
Once his left eye had settled, Mr G asked if there was anything I could do to give his right eye a similar result.
| EDOF: Extended depth of focus lenses are designed to give you a wider range of clear vision than a standard monofocal lens. Depending on the lens and your eyes, this can help with distance and some intermediate or near vision. |
What was the problem?
The fact that Mr G had previously had laser eye surgery made things a little more complicated.
Laser eye surgery changes the shape of the cornea and that can make some of the measurements we use to calculate the right lens implant more difficult to interpret.
In other words, the usual calculations don’t always work as well in an eye that has previously had laser vision correction. Without the right measurements and calculation methods, there is a greater chance of being left with a significant glasses prescription after cataract surgery.
That appeared to be what had happened with Mr G’s right eye.
The good news was that his vision was still very good when corrected with glasses. So rather than there being a problem with the eye’s ability to see, we needed to find a way of correcting the prescription that remained.
How did we approach it?
Fortunately, in situations like this we can use a piggyback lens, sometimes referred to as an “add-on” lens.
In Mr G’s case, we also wanted to get the two eyes working as similarly as possible. His left eye was doing so well with an EDOF lens, so an EDOF piggyback lens was a good fit for what we were trying to achieve.
| Piggyback Lens: A piggyback lens is a very thin lens that is implanted into the eye just in front of the first lens. The lens can correct all types of glasses prescription including myopia (near sight), hyperopia (far sight) and astigmatism (rugby ball shaped eye). |
The result
We implanted an Add-On EDOF lens in Mr G’s right eye to correct the remaining prescription.
For Mr G, the aim wasn’t simply to make the right eye see better. We wanted to bring the two eyes together and give him a similar range of vision in each.
He achieved excellent vision at different distances without glasses, giving him a much more balanced result between his two eyes.
It was a good example of how there can still be options when the result of previous cataract surgery hasn’t been what you hoped for.
The takeaway
If you have previously had lens replacement surgery, it is important that your surgeon takes this into account before calculating the lens implant for cataract surgery.
There are specific measurements and calculation methods that help us get a more predictable result in these eyes. This is the approach we used when planning Mr G’s left eye, which gave him excellent vision without glasses.
Outcome at a glance
Before
6/60
Without his glasses he could only see the largest top letters on the eye chart.
After
3/10
He could see well enough at closer distances to read without glasses.
Could we help you achieve clearer vision?
If you’ve been left with a prescription after previous eye surgery, the first step is understanding exactly what’s going on with your eyes.
Book a consultation with Prof Mohammed Muhtaseb to discuss your vision, your options and what may be achievable for you.
The Add-On lens in the right eye was an ideal solution to balance the eyes and rectify the problem after the initial surgery.
