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clear lens extraction
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|
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| I am having myopia of -16 and -19 D and I am 29 years old , my doctor
advised clear lens extraction because he said that removing the lens
would reduce the risk of retinal detachment , I want to know whether
there is any truth in that statement.
| |
| Glenn - USAEyes.org 2005-07-20, 2:12 pm |
| I have a feeling that something has been left out of your conversation
with your doctor.
Clear Lens Extraction, also known as Refractive Lens Exchange (RLE,
http://www.usaeyes.org/faq/subjects/rle.htm) is the process of
removing the natural lens of the eye and replacing it with an
artificial lens with the correct refractive power.
RLE is exactly the same as cataract surgery. If you live long enough,
just about everyone will develop cataracts and need surgery, but this
normally does not occur until the sixth decade of life, or later.
Myopia (nearsighted, shortsighted) vision is caused by the eye being
elongated. This elongation stretches the retina and puts a lot of
pressure on the connecting points. This pressure can lead to retinal
detachment. A consequence of high myopia, such as the 19.00 diopter
reported by the patient, is retinal detachment.
RLE will not change the shape of the eye, therefore it will not reduce
the stretching of the retina, and will not reduce the probability of
retinal detachment.
The only thing I can think of that might make some sense of the
doctor's statement is that having RLE now may provide a lower risk of
causing retinal detachment during surgery, than having cataract
surgery when you are in your 60s or 70s and your eyes are less
healthy.
You really need to talk this one over with your doctor and ABSOLUTELY
get a second opinion from a retina specialist before having RLE with
such high myopia. Additionally, read the article linked above.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| serebel 2005-07-20, 2:12 pm |
| I couldn't even imagine a -19 script. Wouldn't there be something else
beside an elongated eye to get one there at age 29? Is it possible to
get someone to 20/20 with glasses or contacts with this script ?
SErebel
| |
| Glenn - USAEyes.org 2005-07-20, 2:12 pm |
| Hopefully the patient will respond of his personal experience.
Contacts would almost certainly be difficult to impossible due to the
thickness necessary to provide that much refractive correction. At the
very least, they would be rather uncomfortable. Undoubtedly they
would have a very small optical zone that would cause night vision
problems.
Glasses would work, but even with the best high index material the
outer edges would be thick. You can go to smaller frames, but then you
get even more minimumification of images.
Phakic Intraocular Lenses (P-IOL) would probably not work well for the
same reason as contact lenses. They would be so thick to create that
much refractive correction that there probably would not be enough
room in the anterior segment for them to fit appropriately. Behind
the iris and the natural lens may vault forward with accommodation and
touch the P-IOL, causing a trauma induced cataract. In front of the
iris and disruption of the endothelium layer of the underside of the
cornea would be highly likely. Also, the optical zone of a 19.00
diopter P-IOL would be rather small, contributing to the probability
of night vision problems. A P-IOL might (big emphasis on "might")
work, but careful measurements would be required to know for sure and
the device that takes those measurements is a rare animal.
RLE is about the only viable option, and there are more than enough
concerns there.
Life is not easy for a -19. I can understand the motivation for
refractive surgery.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Ian Hodgson opticians 2005-07-20, 2:12 pm |
|
"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
news:pknod1lnpkp4vscmf7ngldpgsojqkjmv7h@4ax.com...
> Hopefully the patient will respond of his personal experience.
>
> Contacts would almost certainly be difficult to impossible due to the
> thickness necessary to provide that much refractive correction. At the
> very least, they would be rather uncomfortable. Undoubtedly they
> would have a very small optical zone that would cause night vision
> problems.
No problems with contact lenses,Soft lens or GP lenses can be made
to -30.00D,
OZ would be about 8.00mm in diameter same as a normal lens and
the thickness of the lens about 0.13 to 0.15mm, again similar to normal
lens.
> Glasses would work, but even with the best high index material the
> outer edges would be thick. You can go to smaller frames, but then you
> get even more minimumification of images.
On a high index lens the edge thickness would be about 20 mm depending on
the size of frame.
Ideally on this I would use a 1.9 index (glass) material. Minification of
the image is dependant
on lens power not size of lens.
Incidentally from an optical point of view a contact lens would provide a
better optical correction
as the magnifying power of an CL is X1 (unit) magnification, whereas the
spectacle lens will
definitely providing a minified image some 30% smaller. Also peripheral
distortion of the spectacle image
will not exist through a contact lens, but, funnily enough the peripheral
view out of the contact lens
will be restricted compared to the spectacle lens.
> Phakic Intraocular Lenses (P-IOL) would probably not work well for the
> same reason as contact lenses. They would be so thick to create that
> much refractive correction that there probably would not be enough
> room in the anterior segment for them to fit appropriately. Behind
> the iris and the natural lens may vault forward with accommodation and
> touch the P-IOL, causing a trauma induced cataract. In front of the
> iris and disruption of the endothelium layer of the underside of the
> cornea would be highly likely. Also, the optical zone of a 19.00
> diopter P-IOL would be rather small, contributing to the probability
> of night vision problems. A P-IOL might (big emphasis on "might")
> work, but careful measurements would be required to know for sure and
> the device that takes those measurements is a rare animal.
>
> RLE is about the only viable option, and there are more than enough
> concerns there.
>
> Life is not easy for a -19. I can understand the motivation for
> refractive surgery.
>
>
> Glenn Hagele
> Executive Director
> USAEyes.org
>
> "Consider and Choose With Confidence"
>
> Email to glenn dot hagele at usaeyes dot org
>
> http://www.USAEyes.org
> http://www.ComplicatedEyes.org
>
> I am not a doctor.
Ian Hodgson - Isle of Man
| |
| Glenn - USAEyes.org 2005-07-20, 2:12 pm |
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Date: Tue, 19 Jul 2005 17:19:34 GMT
Xref: number1.nntp.dca.giganews.com alt.lasik-eyes:45723
Excellent information Ian, and thanks for correcting my errors.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Ragnar 2005-07-20, 2:12 pm |
| is that ALL he gave as an explanation? LASIK can only take care of
about -14 D so even after LASIK you would have -2D and -5D. You
didn't mention how old you are.
Before having anything done, I would go to another ophthalmologist for
a consultation and ask him what your options are. Retinal detachment
isn't the issue here.
On 18 Jul 2005 00:19:16 -0700, "Fovea" <shivakumar252@hotmail.com>
wrote:
> I am having myopia of -16 and -19 D and I am 29 years old , my doctor
>advised clear lens extraction because he said that removing the lens
>would reduce the risk of retinal detachment , I want to know whether
>there is any truth in that statement.
| |
| Ragnar 2005-07-20, 2:12 pm |
| Your post triggered my memory about something important. Glasses are a
relatively thick piece of material (glass or plastic). Glasses for
farsightedness are similar to a magfifying glass - so the stronger the
prescritption, the larger objects appear. This is why people with
strong glasses for farsightedness look like their eyes are HUGE. The
lenses are magnifying their eyes.
Conversely, glasses for nearsightedness have a minification effect.
And with an Rx of -19, even if the objects are in focus, they are
going to be SMALL. Yet another reason to avoid glasses.
One idea I think the poster should consider is to have LASIK done to
bring him down to -2D and -5D and then wear contact lenses to complete
the correction. Contact lenses aren't able to correct for -19 on
their own. If the person is approaching cataract age, then a CLE may
be a better option.
On 18 Jul 2005 18:01:29 -0700, "serebel" <serebel@aol.com> wrote:
>I couldn't even imagine a -19 script. Wouldn't there be something else
>beside an elongated eye to get one there at age 29? Is it possible to
>get someone to 20/20 with glasses or contacts with this script ?
>
>SErebel
| |
| CatmanX 2005-07-20, 2:12 pm |
| I would certainly be looking at CLE as Lasik is not good over -8.00 and
the optic would be too small and the chances of needing multiple
surgeries increases dramatically.
RLE is much more stable, gives better visual results and faster.
Make sure the surgeon is well practiced at the procedure and is also a
top-notch cataract surgeon.
Do some enquiring, get a few opinions and go for the best guy, it will
be worth it in the long run.
dr grant
| |
|
| well let me go a little further , my doctor says that i have a an
immature cataract (, though the other doctors dont agree on this ) he
says that the cataractous lens discharges toxic materials that can
increase retinal degeneration and hence increase the incidence of
retinal detachment , therefore he advises CLE.
| |
| Glenn - USAEyes.org 2005-07-20, 2:12 pm |
| I suggest you rely more on the opinion of the other doctors...a lot
more.
| |
| CatmanX 2005-07-20, 2:12 pm |
| My thoughts are CLE is the only option if you are looking at refractive
surgery.
At 29, it is very unlikely that you have CATARACT, although this is a
term used for any lens opacity. You may have sutural cataract, minor
congenital cataract, or some other anomaly, but it is rare at your age
to have nuclear sclerosis unless there is strong family history or
trauma/chemical/medication issues.
If you don't want surgery, then contacts and glasses are going to suit
you well. You need to do what you feel comfortable with, not get pushed
into something.
dr grant
| |
| Ragnar 2005-07-22, 8:59 am |
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Date: Fri, 22 Jul 2005 04:26:32 GMT
Xref: number1.nntp.dca.giganews.com alt.lasik-eyes:45748
A -30D soft contact? Who makes that?
Also, higher refractive errors coincide with higher astigmatism.
Thankfully, there aren't many people with such severe refractive
errors.
On Tue, 19 Jul 2005 11:08:19 +0100, "Ian Hodgson opticians"
<lookman@enterprise.net> wrote:
>
>"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
>news:pknod1lnpkp4vscmf7ngldpgsojqkjmv7h@4ax.com...
>
>No problems with contact lenses,Soft lens or GP lenses can be made
>to -30.00D,
>OZ would be about 8.00mm in diameter same as a normal lens and
>the thickness of the lens about 0.13 to 0.15mm, again similar to normal
>lens.
>
>
>On a high index lens the edge thickness would be about 20 mm depending on
>the size of frame.
>Ideally on this I would use a 1.9 index (glass) material. Minification of
>the image is dependant
>on lens power not size of lens.
>Incidentally from an optical point of view a contact lens would provide a
>better optical correction
>as the magnifying power of an CL is X1 (unit) magnification, whereas the
>spectacle lens will
>definitely providing a minified image some 30% smaller. Also peripheral
>distortion of the spectacle image
>will not exist through a contact lens, but, funnily enough the peripheral
>view out of the contact lens
>will be restricted compared to the spectacle lens.
>
>
>Ian Hodgson - Isle of Man
>
| |
| Ian Hodgson opticians 2005-07-22, 11:52 am |
|
"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
news:s4t0e152q232l5fqd5np0qp2oikn04tqcd@4ax.com...
> A -30D soft contact? Who makes that?
Cantor & Nissel Ltd of Brackley Northamptonshire UK
As David Cantor was telling a group of us onetime the worse patient they
ever fitted was a lion in a UK zoo. The after care was done outside the
cage!
Regards
Ian Hodgson - Isle of Man
> Also, higher refractive errors coincide with higher astigmatism.
> Thankfully, there aren't many people with such severe refractive
> errors.
>
>
> On Tue, 19 Jul 2005 11:08:19 +0100, "Ian Hodgson opticians"
> <lookman@enterprise.net> wrote:
>
of[vbcol=seagreen]
>
| |
| serebel 2005-07-22, 10:50 pm |
|
Ian Hodgson opticians wrote:
> "Ragnar" <ragnarsuomi@yahoo.com> wrote in message
> news:s4t0e152q232l5fqd5np0qp2oikn04tqcd@4ax.com...
>
> Cantor & Nissel Ltd of Brackley Northamptonshire UK
>
> As David Cantor was telling a group of us onetime the worse patient they
> ever fitted was a lion in a UK zoo. The after care was done outside the
> cage!
>
>
Okay, I'll bite. How does one get the lion to say which is better, 1
or 2 ???
SErebel
| |
| CatmanX 2005-07-23, 8:50 am |
| It is easy, ask him!!!
Actually, you use a retinoscope and that tells you whether to add more
or less power. It is how we get glasses for newborns, non-english
speakers, illiterates etc. AN autorefractor is just a computerised one
of these.
dr grant
| |
|
| In article <1122093676.765409.102250@g14g2000cwa.googlegroups.com>,
"CatmanX" <grantm@connexus.net.au> wrote:
> It is easy, ask him!!!
>
> Actually, you use a retinoscope and that tells you whether to add more
> or less power. It is how we get glasses for newborns, non-english
> speakers, illiterates etc. AN autorefractor is just a computerised one
> of these.
>
> dr grant
Why illiterates? Unless it's an illiterate cat, an illiterate person
can tell you which is clearer, 1 or 2.
What a windfall for retinoscopes and autorefractors since most of the
world is non-English speaking!
BTW, how many newborns wear glasses. An approximation is fine. I
wonder if mothers remove them before breast-feeding. Well, I guess if
the newborn was farsighted, s/he would need glasses to find the nipple.
--
~RT
| |
| Ragnar 2005-07-25, 12:22 am |
| hmm.. tell that doctor to quit calling it CLE if you have a cataract.
That will save you from putting money out of your own pocket.
On 19 Jul 2005 22:25:46 -0700, "Fovea" <shivakumar252@hotmail.com>
wrote:
>well let me go a little further , my doctor says that i have a an
>immature cataract (, though the other doctors dont agree on this ) he
>says that the cataractous lens discharges toxic materials that can
>increase retinal degeneration and hence increase the incidence of
>retinal detachment , therefore he advises CLE.
| |
| Ragnar 2005-07-25, 12:22 am |
| Does the lion take his lenses out every night?
Why does a lion in a zoo need good vision?
It might be better to not see so well so he doesn't know he's living
in a 400 foot concrete enclosure. with bars
On Fri, 22 Jul 2005 16:15:49 +0100, "Ian Hodgson opticians"
<lookman@enterprise.net> wrote:
>
>"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
>news:s4t0e152q232l5fqd5np0qp2oikn04tqcd@4ax.com...
>
>Cantor & Nissel Ltd of Brackley Northamptonshire UK
>
>As David Cantor was telling a group of us onetime the worse patient they
>ever fitted was a lion in a UK zoo. The after care was done outside the
>cage!
>
>Regards
>
>Ian Hodgson - Isle of Man
>of
>
| |
| Ian Hodgson opticians 2005-07-25, 10:37 am |
|
"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
news:j8q8e19qluelsld3f3ndg9ehoshliu201i@4ax.com...
> Does the lion take his lenses out every night?
>
> Why does a lion in a zoo need good vision?
> It might be better to not see so well so he doesn't know he's living
> in a 400 foot concrete enclosure. with bars
>
Never heard of bandage contact lenses? I think the lion concerned had had a
severe
eye injury.
Also most UK 'Zoos' are now large wildlife parks with the enclosures for
animals like
lions etc being several acres of field.
There was even the possiblity of me having to fit a bandage lens to a horse
(suffering from RCE)
with the aid of a vet. Didn't happen as the problem cured itself.
Regards
Ian Hodgson - Isle of Man
> On Fri, 22 Jul 2005 16:15:49 +0100, "Ian Hodgson opticians"
> <lookman@enterprise.net> wrote:
>
message[vbcol=seagreen]
the[vbcol=seagreen]
the[vbcol=seagreen]
normal[vbcol=seagreen]
you[vbcol=seagreen]
on[vbcol=seagreen]
Minification[vbcol=seagreen]
provide a[vbcol=seagreen]
the[vbcol=seagreen]
peripheral[vbcol=seagreen]
peripheral[vbcol=seagreen]
the[vbcol=seagreen]
and[vbcol=seagreen]
and[vbcol=seagreen]
>
| |
| Ragnar 2005-07-26, 6:02 pm |
| OH! A contact bandage lens might be appropriate. I would guess that
what would be done with that is to put in the contact lens and sew the
eye shut while the eye healed.
As zoos go, I think that the UK has some of the best... but I'm not
convinced that any zoo could possibly provide a suffient amount of
territory to roam about. Lions are nomadic. But then.. they put
killer whales in giant salt-water fishing pools..
On Mon, 25 Jul 2005 09:29:19 +0100, "Ian Hodgson opticians"
<lookman@enterprise.net> wrote:
>
>"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
>news:j8q8e19qluelsld3f3ndg9ehoshliu201i@4ax.com...
>Never heard of bandage contact lenses? I think the lion concerned had had a
>severe
>eye injury.
>Also most UK 'Zoos' are now large wildlife parks with the enclosures for
>animals like
>lions etc being several acres of field.
> There was even the possiblity of me having to fit a bandage lens to a horse
>(suffering from RCE)
>with the aid of a vet. Didn't happen as the problem cured itself.
>
>Regards
>
>
>
>Ian Hodgson - Isle of Man
>
>
>
>message
>the
>the
>normal
>you
>on
>Minification
>provide a
>the
>peripheral
>peripheral
>the
>and
>and
>
| |
| Teddy 2005-08-17, 10:57 pm |
| Well, it would increase the chances of endothelial cell loss. Nobody knows
the
long term consequences of that! I'd stay away from all forms of refractive
surgery
with your prescription. You definitely don't want corneal refractive surgery
because
you would have no cornea LEFT after a correction that high.
Glasses work. Learn to love them!
"Fovea" <shivakumar252@hotmail.com> wrote in message
news:1121671156.243315.60530@z14g2000cwz.googlegroups.com...
> I am having myopia of -16 and -19 D and I am 29 years old , my doctor
> advised clear lens extraction because he said that removing the lens
> would reduce the risk of retinal detachment , I want to know whether
> there is any truth in that statement.
>
| |
| Teddy 2005-08-17, 10:57 pm |
| You never thank me for correcting your errors. I'm at it pretty hard. It's a
big job.
Sandy Keller deserves some thanks as well, and Brent Hanson. Excellent job,
folks.
Raise the BS flag when Glenn starts spewing nonsense. Which is, well....
always.
"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
news:5gdqd1dh9jbuhh6s2o4ffnm4gfm8uvdu9s@4ax.com...
> Excellent information Ian, and thanks for correcting my errors.
>
> Glenn Hagele
> Executive Director
> USAEyes.org
>
> "Consider and Choose With Confidence"
>
> Email to glenn dot hagele at usaeyes dot org
>
> http://www.USAEyes.org
> http://www.ComplicatedEyes.org
>
> I am not a doctor.
| |
| Glenn - USAEyes.org 2005-08-17, 10:57 pm |
| "Teddy",
What, exactly, have I stated that is inaccurate? Please quote me and
back up your accusations with independently affirmed fact, not just
your opinion.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Glenn - USAEyes.org 2005-08-17, 10:57 pm |
| There are no studies in the past six decades of the use of an aphakic
intraocular lens (IOL) used with clear lens extraction (also called
refractive lens exchange) that indicates any progressive endothelial
cell loss and the loss that occurs during surgery is not significant
enough to cause problems with a healthy eye.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| serebel 2005-08-17, 10:57 pm |
| Since Teddy here is a Keller and Hanson fan, it speaks volumes to his
credibility right from the start.
SErebel
|
| |
|
|