Cataract surgery after LASIK, PRK or RK is possible, but more involved that surgery on a virgin eye. When selecting the appropriate replacement lens implant, Dr. Pascucci performs detailed calculations to determine the correct lens power you will need to see well after surgery. When you originally had LASIK, or PRK, or RK, the primary measurement considered for your treatment was the curvature of your cornea – whether it was too steep (nearsighted), too flat (farsighted) or out of round (astigmatism).
The new changes in your eye are now likely related to the lens, rather than the cornea. As this lens became less flexible, you developed presbyopia and had to hold things further and further away, with good lighting, to read. And the lens itself became discolored and cloudy, which is a cataract.
When Dr. Pascucci evaluates which lens implant to give you after cataract removal, he considers three things:
-Axial length -Anterior chamber depth -Corneal power
An error in any of these three parameters can lead to a refractive surprise, meaning your vision after surgery is not what we, or you, desire. Improvements in technology have allowed us to more precisely measure axial length and anterior chamber depth, improving accuracy and visual acuity after cataract surgery. These two measurements are not materially affected by previous LASIK, PRK or RK. However, corneal power is the third critical element of preoperative lens measurements, and is where we take extra care with our measurements for cataract surgery after LASIK.
Secure Your Pre-LASIK Medical Records
Different types of refractive surgery fundamentally alter corneal shape and power, and offer considerable challenge selecting the optimal lens implant and power for you in cataract surgery. The corneal curvature of your natural eye (before LASIK) is/was expressed in “Ks”. These preoperative numbers are preferred for Dr. Pascucci to accurately select the power of lens implant for you. You may have these “Ks” from your LASIK medical records, or you may have been given this information on a wallet card in your post-operative LASIK care. Your best result can be targeted with this original corneal data. If you don’t have this information, the staff at Eye Consultants will do thorough testing to attempt to pinpoint the best lens choice for you.
Expect an Increased Likelihood of Enhancement
Post-LASIK cataract patients can expect an increased rate of excimer laser enhancement after cataract surgery. We anticipate 1 out of 4 of our post-LASIK patients will require touch-up. While this shouldn’t deter you from proceeding with cataract surgery, and we’re sure you’ll enjoy greatly improved vision afterward, we want you to be aware that the challenge in surgical planning is greater, and the path to your best vision may require a touch-up procedure.
The fee for cataract surgery after LASIK is +$500 vs. standard lens surgery and lens implant costs, as detailed here.
Dr. Pascucci is a Post-LASIK Cataract Surgery Specialist
Dr. Pascucci specializes in cataract surgery for the post-LASIK patient. He, himself has had LASIK, and has studied the unique requirements and calculations for lens selection that yield optimal post-cataract results. Please contact us if you’ve had LASIK, are now considering cataract surgery, and would like to discuss your options further.