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TO YOUR GOOD HEALTH #12345_20220728
FOR RELEASE WEEK OF JULY 25, 2022 (COL. 4)
BY LINE: By Keith Roach, MD
TITLE: Adjustable Light Lenses in Cataract Surgery Yield Better Outcomes
DEAR DR. ROACH: I’m a candidate for cataract surgery. While discussing this with my doctor, he mentioned to me that there are new lenses that can be used which correct my vision to 20/20. They are called light-adjustable lenses. There is a cost of $2,400 per eye. It seems to have a lot of success with little risk. He mentioned that I should wear sun protection goggles all the time until the vision is fixed. My question is, is it worth it? It sounds very appealing to have the operation and know that my vision will be perfect afterwards; whereas with the regular lens, there is no guarantee that my vision will improve. Your thoughts? — Sask.
ANSWER: First of all, there is never a 100% guarantee in surgery. In any surgery, a small number of people will have unwanted complications and some will be disappointed with their results. Cataract surgery is one of the most successful and least risky surgeries, but bad results still rarely occur.
The light adjustable lens is a new type of lens (approved in 2017) that allows the ophthalmologist to adjust the strength of the lens after it has been placed in your eye. In any type of cataract surgery, the eye is measured for the correct lens strength, but post-operative changes in the eye can cause the new lens to focus light inaccurately. The light-adjustable implanted lens can be adjusted to make focusing precise.
Ultraviolet light is used to refine the strength of the lens. Usually two to four light treatments are used, each lasting around 90 seconds and three days apart, to “lock in” the new strength. As you noted, you should stay away from strong ultraviolet light, such as the sun, until the new lenses are locked in.
Results after one year show that 93.4% of people fitted with the light-adjustable lens have vision of 20/20 or better, compared to 82.4% of people given a standard lens. In both groups, 100% had vision of 20/40 or better. People with persistent refractive error may need to wear glasses or contact lenses even after surgery, but this is less likely with the light-adjustable lens.
Is it worth it? I can’t answer that because it depends on your resources and how important it is to you to have a better chance of having excellent vision. Although $4,800 is a lot of money for both eyes, if you are lucky enough to have it available to you, the vision results after surgery are better.
DEAR DR. ROACH: I have a question regarding coughing upon waking and within 30 minutes of eating. The worst thing is that I keep coughing until a thick secretion from my stomach comes out. — Maya
ANSWER: Coughing first thing in the morning usually means your body is getting rid of secretions that have built up overnight. These can come from the nasal passages and sinuses, or from the esophagus or stomach, in people with GERD, or from the lungs.
Thick secretions are more likely to come from the nasal passages and sinuses. Your regular doctor or an ear, nose and throat specialist might be able to help you diagnose and treat the underlying condition – such as allergies, infections, or smoking – that is causing these secretions.
Since coughing also occurs after eating, I suspect there may be a condition called vasomotor rhinitis, which is a common cause of coughing.
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Dr Roach regrets that he cannot respond to individual letters, but will incorporate them into the column whenever possible. Readers can email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.
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