cataract surgery after lasik

A popular misconception is that Lasik makes cataract surgery more difficult. Actually the surgery is identical. The problems arises in picking the new intraocular lens. Lasik surgery makes these calculations more difficult. Therefore, if the new lens is intended to correct one's distance vision so they still don't need distance glasses, the patient may end up myopic or hyperopic, essentially requiring glasses now to see well at distance. The normal measurements are dependent on accurately measuring the cornea's anterior curvature but lasik changes the relationship between the anterior and posterior curvature leading to inaccurate results. However, newer formulas have helped alleviate some of this difficulty. The most important advice I can give you, the patient, is have records of your lasik workup available for your cataract surgeon. This will allow your surgeon to be more precise in the new lens calculation.

Mr. H, a 47 year old man had Lasik surgery 5 years ago. Fortunately he had a wonderful result. A few months ago he developed blurred vison in his right eye. This made it difficult for him to drive, play golf, or even read at times. I saw him for the first time one month ago. He had a significant cataract. We discussed the difficulties in implant calculation. I was able to obtain the Lasik work-up measurements from elsewhere and use these numbers to calculate the implant power. I used a few different formulas.
On the day of the surgery, all went well. This was expected since I told him he had only a 2% chance of a complication. The real anxiety comes from learning what his vision is without glasses the day after surgery. Mr. H is a fairly non-emotional man. The day after surgery I walked into the exam room and asked him how he was doing. He said fine. That's all. Fortunately his vision was about 20/30 without glasses for distance. This bodes well. As his eye settles down in the next few weeks, I believe he will do well. If his vision were not good on the first day after surgery, I could attribute this to either a cloudy cornea from the stress of surgery, which will clear in the next few days, or that my calculations were off and he really will need glasses for good distance vision.
Bottom line, he can always be helped. We can discuss this in future posts.