Enhancements

Once surgery is completed and healed, vision after surgery is remarkably stable. However, as with all surgery, no one can guarantee the outcome and a variety of factors can lead to variations in the refractive result. One strength of lens based surgery is the rich variety of enhancements possible after the surgery. These enhancements fall into four categories: correction of astigmatism, LASIK to correct near or farsightedness, YAG laser to remove clouding in the capsule after surgery and exchange of the intraocular lens itself and/or placement of a "piggyback lens."

Correction of Astigmatism

In astigmatism, the cornea is oval instead of round. Astigmatism is often present before surgery and is sometimes induced by surgery. Correction is usually performed in the first month or two following surgery as part of the normal exam.

This surgery is usually performed right in the exam room, using drops to numb the eye. There is almost immediate visual improvement with little or no pain. This technique was developed by Dr. Buzard and represents a dramatic development in the control of astigmatism.

LASIK for Near and Farsightedness

LASIK can be used as an enhancement. It can be used to control astigmatism, near or farsightedness after a lens based surgery has been performed.

THE YAG LASER

The capsule that holds the lens in place will sometimes cloud, at times as soon as 3-6 months after the original surgery, causing vision to become correspondingly clouded.

This can result in symptoms similar to the original cataract such as glare at night and blurred vision. In fact, this problem was often called a "second cataract" in the past, although it is not really a recurrence of the original cataract. Fortunately, the YAG laser capsulotomy is a painless procedure taking only a few minutes. In this procedure, the laser light comes to a focus on the posterior capsule and causes a small "pop" which creates an opening in the capsule. The clouding does not usually recur.

Sutureless IOL Exchange

Another possible enhancement option is exchange of the intraocular lens. Exchange of the intraocular lens (shown below) can alter the refractive result of the surgery and using Dr. Buzard’s technique, can even be done without sutures! This technique can be used to improve vision without glasses and to reverse or add monovision correction.

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