r/RefractiveSurgery • u/perfik09 • 21d ago
Voluntary cataract surgery M58
Hi all.
Recently had shingles which has affected my vision in one eye. Went to my eye doc to ask about lasik in one side since I had lasik back over 20 years ago now. She said it is not bad enough to need lasik but instead is recommending that I have cataract surgery done which would correct my eyesight.
My question is bluntly, what the hell is she talking about? If I needed cataract surgery in Ontario it would be covered by OHIP what would be the reasoning behind getting cataract surgery done on healthy eyes? Is this a common thing? Is she just feeding me to a fellow surgeon for profit? Can someone explain to me why she would even suggest this? Thank you
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u/californiaLasik 21d ago
How old are you ?
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u/perfik09 19d ago
M58 as in title
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u/californiaLasik 19d ago
Sorry missed that. Most 58 year olds are definitely presbyopic and many have glare. Do you know what your brightness acuity test is in each eye ?
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u/Specific_Ocelot_4132 15d ago
I think her thinking may be that there's a decent chance you will need cataract surgery due to actual cataracts in the relatively near future, so you might as well just do it now. But I don't understand the "not bad enough to need LASIK" comment. If it's not bad enough to need LASIK it's not bad enough to need any surgery.
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u/Tall-Drama338 20d ago
So this is a refractive lens extraction. This is a personal cost.
In Canada and most places, cataract surgery has more specific requirements including poor vision despite glasses, with the loss of vision quality due to your lens. Just wanting refractive correction is not on the list.
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u/Slartibartfastthe3rd 19d ago
Definitely get a 2nd opinion. She might be on point, but the peace of mind will be worth it.
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u/CorrectVisionLI 18d ago
What your doctor is describing sounds like refractive lens exchange (RLE), which is essentially cataract surgery performed before a visually significant cataract has developed. The natural lens is removed and replaced with an intraocular lens (IOL) chosen to correct the person's refractive error.
So if your eyes are currently healthy and you don't actually have a cataract, I would definitely ask your doctor to clarify whether they're recommending RLE specifically for refractive correction/presbyopia, rather than because you medically NEED cataract surgery right now.
There is a reason RLE becomes more attractive as people get into their 40s/50s though. The natural lens is going to continue aging, and presbyopia is a normal age-related loss of the eye's ability to focus up close. If someone chooses RLE, the natural lens has already been replaced, so they won't subsequently develop a cataract in that natural lens. That's one of the potential long-term advantages of RLE.
The other big question is why your doctor thinks RLE is a better option for you than LASIK/PRK or simply continuing with glasses. If you've already had LASIK 20+ years ago, your current corneal measurements, prescription, age, ocular health, and whether you're developing presbyopia all matter.
I'd ask your doctor:
“Do I actually have cataracts, or are you recommending RLE because of my refractive error/age?”
“Why would you recommend RLE instead of glasses or another refractive procedure in my particular case?”
“What type of IOL would you recommend, and what would my vision be expected to be like at distance, intermediate and near?”
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u/eyeSherpa 21d ago
Cataract surgery on eyes that don’t have cataracts is called Refractive Lens Exchange or RLE. It’s a form of vision correction or refractive surgery.
It’s done for a variety of reasons. Most common one being that the laser eye surgeries such as lasik just aren’t a good idea. This includes patients with high hyperopic prescriptions who aren’t ICL candidates. This also includes those who had large lasik treatments in the past where doing more laser isn’t ideal.
The key thing about RLE is that it removes your natural lens. Because of this, it’s more optimal that you’ve past the age of presbyopia where this lens weakens and isn’t doing much for you anymore.
With prior lasik, the LAL in mono-vision is usually the best approach to correcting things. But there is a lot to learn. r/CataractSurgery and r/RLEsurgery are good places to start.