Scleral lens disappointment

[dplees]

I've previously had: cxl, intacs, toric phakic oil and lipiview

Since these treatments I've men left with a small prescription in my right eye and I still get ghosting .
Yesterday I went for a scleral lens fitting and was unfortunately quite disappointed, scleral lenses are phenomenally comfortable, however are not compatible with pre existing "toric" IOls.
If anyone does take the same route as I, I'd have a good think about trying sclerals before going down the lens implant route

[DrG]

Sorry to hear about your disappointment, but surely this can't be true. Why did the lens fail? Was it because of some induced astigmatism? If that is the case then you and everybody else surely need to know that scleral lenses do exist that can correct every type of astigmatism.

[dplees]

Hello drg,

I've since spoken to the surgeon who implanted the toric oil and he's told me that he wouldn't expect the toric scleral to work on top of a toric iol - have you ever had this situation? I remember the lens fitter saying that the lens rotated a lot also, so getting good vision would be impossible - the fit felt excellent. Such a shame

[DrG]

I never cease to be appalled by some of the things I hear. I won't speak for others, just for myself.

I have spent quite a few years developing a non-rotational scleral lens. This is a pre-requisite for the correction of astigmatism with any lens. Most of the cases I treat have some form of astigmatism that is induced by the lens, i.e. wasn't there or different when I put a lens on the eye. A toric scleral lens is therefore necessary. Sometimes even after that there is additional astigmatism that requires a different toric prescription. I have a calculator that figures out the correction I need based upon the prescription in the lens and the over-refraction. The result of that is usually right on the money. The message here is that I disagree with your surgeon, who may need to go back to optics school.

Then there are the higher order aberrations, etc., etc., that I deal with every day and cause double vision, but now I am talking about things that are not available in the UK.

However, can you tell me if your surgeon bothered to calculate a refraction over the IOL, and when it was put into a trial frame did it correct your vision?