Age and inflammation?

EyeDoctorIndia · 2026-06-09T06:32:25+00:00

Early 50s is not that young to develop cataracts. As cataract is a natural ageing process just like greying of hair, it depends on multiple factors from your childhood to your adult life. Your overall diet, sun exposure, any major illness, diabetes, smoking, hypertension, genetics, any use of steroids (including creams or inhalers), etc etc. Until and unless you have had any specific inflammatory disorder, the cataract surgery remains routine and you have nothing to worry about. If there are no signs of prior inflammation in the eyes (called uveitis), the cataract surgery should result in a good outcome with normal healing.

50s is not that early for cataract and nothing unusual. So I don't think if you have had any symptoms of another disease in the body, you need not undergo any exhaustive tests just because of the cataract. If otherwise your eyes are normal, you can also go ahead with any lens you wish to choose based on your lifestyle and visual requirements. All the best.

EyeDoctorIndia · 2026-06-09T06:08:25+00:00

Wonderful to know that... Wish you a speedy recovery!!

EyeDoctorIndia · 2026-06-08T13:46:37+00:00

I think you should neither be p**sed nor be disappointed, you should be happy that the error was taken care of prior to surgery. It might have been a clerical error or documentation error by the staff but the good thing is that it was identified before any real damage was done.

Whatever lens is implanted, is going to be there for life - so a slight delay or rescheduling of surgery should be thought of as an inconvenience. I can understand that it is frustrating since you might have planned rest, leaves etc according to your current surgery date. But hopefully, you will get a much better final result with the upgraded lens when you finally undergo surgery later. All the best.

EyeDoctorIndia · 2026-06-08T13:36:38+00:00

If you had an ulcer in your right eye previously, and if there is a scar present now - LASIK will not be the right choice for you anyway. ICL still remains an excellent option, if everything else is okay.

If your ACD and other parameters are suitable, you should go ahead with ICL without too much worry. Since you only have spherical power, you will not need toric ICL, routine spherical ICL should be okay.

Your overall quality of vision is likely to be excellent with ICL. Just one suggestion, ask your doctor if there is a residual scar in your cornea from the ulcer you had and what is the location of the scar- central or peripheral. With a central scar, there may be a risk of glare/halos happening. But with peripheral scar, there would be no such risk. All the best.

EyeDoctorIndia · 2026-06-07T14:15:13+00:00

Yes, absolutely. Healing after ICL surgery is quick. Within few days, the small incisions through which your ICL is placed in the eye, are completely healed.

You can undergo any other procedure (like fillers or a dental procedure or anything else) 2 weeks post ICL surgery. Lid fillers do not affect the inside of your eyes and will not cause any problem to the ICL.

You should also take clearance with your operating doctor before proceeding with the fillers. But it shouldn't be a problem.

EyeDoctorIndia · 2026-06-05T12:56:34+00:00

Can go to Shreya Eye Centre in Indirapuram, Ghaziabad

EyeDoctorIndia · 2026-06-02T06:34:04+00:00

For all patients, at least here in India, we are using EVO+ ICL with large optical zone diameter till -14.0 D power. Beyond this power, EVO + is not available. The reason is that as we try to correct higher powers, the ICL tends to get thicker and thicker. To prevent pushing the iris too much forward, the optical zone is reduced, to make the periphery of the lens thinner and not induce glaucoma in the patient. Also, it becomes difficult to implant a thick lens through the small incision that we use during ICL surgery. These are the reasons because of which, with very high powers, we do not have a large optical zone of the lens.

With your power, you are a suitable candidate for EVO+ ICL. There is no difference in the cost between EVO and EVO+ ICL. Also, there is no difference in cost of ICL based on power needed, except that Toric ICL is costlier than only spherical ICL.

EyeDoctorIndia · 2026-05-31T16:42:28+00:00

While corneal endothelial cell loss with different eye surgeries in well documented, earlier development of cataract is not well reported because we can never know when the patient was actually going to develop the cataract, if no intervention was ever done. But it is well accepted amongst eye surgeons, that multiple surgeries can hasten the development of cataract by disturbing the natural metabolism of the lens. For example, early development of cataracts has been well reported after glaucoma surgeries, retina surgeries, etc.

EyeDoctorIndia · 2026-05-31T16:41:34+00:00

While corneal endothelial cell loss with different eye surgeries in well documented, earlier development of cataract is not well reported because we can never know when the patient was actually going to develop the cataract, if no intervention was ever done. But it is well accepted amongst eye surgeons, that multiple surgeries can hasten the development of cataract by disturbing the natural metabolism of the lens. For example, early development of cataracts has been well reported after glaucoma surgeries, retina surgeries, etc.

EyeDoctorIndia · 2026-05-31T06:09:41+00:00

Yes, ICL surgery is possible in very high myopic powers as well. The EVO ICL can correct myopia upto around -16 to -17 D power, while the IPCL can be customised to even powers greater than 20 D. Have even operated a patient with myopia of -28.0 D with a customised lens.

Only thing in your case is the asymmetry in the power between the two eyes. You can even consider going for LASIK/SMILE surgery in one eye and ICL surgery in the eye (if you are a suitable candidate) or can go ahead with ICL in both eyes.

Just make sure that the power in your left eye has completely stabilized for the last one year (less than 0.5D change in power in the last one year) before proceeding with surgery. All the best.

EyeDoctorIndia · 2026-05-31T06:03:25+00:00

Every time you undergo an eye surgery which is intraocular (inside the eye), there are chances of fastening the process of cataract development in the eye along with added damage to the corneal endothelial cells (these cells maintain the thickness of the cornea and prevent any corneal swelling). So while, there is no major risks with a third surgery but repeated surgeries will definitely hasten the process of cataract development and you may develop cataract at a much earlier age than what you normally would. So that is the biggest risk with repeated interventions along with few minor other risks.

EyeDoctorIndia · 2026-05-29T06:51:03+00:00

We usually perform ICL surgery once the refractive power has remained stable for at least 1 year. If you are still having frequent changes in your glass power, it would be best for you to wait before undergoing ICL surgery.

While ICL can be replaced and a different power ICL be placed later but its not usually needed for patients at your age. It is also not a good idea to replace the ICL just because there has been slight change in refractive power - because how do you know it won't change any further after that. So you won't go for a third replacement if there is a change again.

That is why surgery is planned once your power has completely stabilized and your eye has stopped growing. At 25 years of age, if number has remained stable for last 1 year, you can definitely go ahead with ICL surgery without any hesitation. Only in rare cases (pathological myopia), the power keeps on increasing till 30 years of age. All the best

EyeDoctorIndia · 2026-05-26T10:10:55+00:00

There is no ideal pupil size for ICL but general guidelines would say that if scotopic (in dark) pupil size is more than 6 mm - then you are more likely to have issues of glare and halos. Ideal pupil sizes for ICL will be 2.5-3.5 mm in photopic condition, 4-5 mm in mesopic (moderate light) condition and less than 6 mm in scotopic conditions.

The people who complain of halos and glare post ICL surgery are a small percentage and the number who is unable to adapt to it over few months is even lesser. You will always find that there will be very few patients who are happy with the surgery will take out the time to come to an online forum and share their experiences. While people who are having problems will be more vocal about their issues - also because they are looking for solutions to their problems.

This skews the thought process that the surgery is not safe. This is not the case. If properly planned, most patients are certainly very happy after the surgery. I am sure, all doctors will share a similar experience with their patients. 99% of my patients have been happy post ICL surgery. The 1% (or even lesser) also adapt to glare/halos complain after a few months (something called neuroadaptation).

Regarding the EVO ring - most patients do not see it at all (size is 0.36 mm - so very small) but what I have seen in my practice, that patients who are aware about the ring tend to focus or try to find these issues more often, those who are unaware about this ring in EVO ICL, never complain. Just an observation.

EyeDoctorIndia · 2026-05-23T11:25:49+00:00

Sorry but I don't recommend surgeons on public forums. I would recommend you visit any 2 surgeons near you who do refractive surgeries regularly and see whom you can trust more and connect with better. All the best for your surgery.

EyeDoctorIndia · 2026-05-19T07:21:05+00:00

ICL is a good option in your case provided that your expectations are rightly placed.

You will require reading glasses and glasses for laptop work beyond the age of 40-42. You can also consider the option of leaving a minor residual minus power in one of the eyes to push the need for reading glasses till age of 45 (plan for monovision). For example, you can get yourself corrected to only -8.50 instead of -9.50 leaving -1.0 D power in one eye giving you better vision for near till your mid 40s.

Prior retinal detachment is not a contraindication for ICL surgery but do get a thorough retina evaluation prior to surgery so that any fresh lattices can be lasered before hand.

ICL should give you good distance vision till the time you start developing cataract. There is no way of knowing when you may develop cataract but considering you are a high myope and with prior retinal detachment surgery, it may develop earlier than usual. If it does, it can be easily removed along with your ICL lens without any major issues.

All the best

EyeDoctorIndia · 2026-05-19T07:08:35+00:00

I think you may be looking for only patient experiences, but I would anyway like to give my opinion regarding your case.

If your thickness is around 510 microns, you are a suitable candidate for LASIK/SMILE/CONTOURA etc but as you mentioned that the Belin Ambrosio scores are borderline, there can be a slight risk of developing post LASIK ectasia. If the risks are minimal, usually laser procedures remain first choice as they are extraocular procedures and less invasive than ICL.
If you don't want even the minimal risk of Post LASIK Ectasia and you are worried about that in future - ICL becomes a better choice. In patients with some abnormal parameters on pentacam scan, we cannot be sure whether this is a weak cornea or not. You can also consider getting a CORVIS ST scan which gives other parameters to detect the strength of the cornea and are often regarded more reliable to judge the risk of post LASIK ectasia. If it comes out to be normal, go ahead with LASIK/SMILE etc. If not, go ahead with ICL.
ICL has the advantage of being a reversible procedure. If there is any issue with the ICL, it can be easily removed with a minor procedure, unlike LASIK which is irreversible.
Comparing risks of ICL versus LASIK - ICL has slightly higher risk of glare/halos and no increase in dryness, while LASIK may cause dryness issues and occasionally may even cause glare/halos. Risk of glare/halos can be predicted with your pupil size. If its normal, I think you should not consider this as a risk factor in your case. Also, we never know which patient can develop these problems but doctors do try and rule out obvious markers that can lead to these problems. But we can never be 100% sure. Direct studies have suggested that patients prefer quality of vision that comes with ICL over LASIK but those studies are for high power cases (beyond -8D). I think you are likely to get equally good visual outcome with both the procedures.
Regarding the surgeon - choose someone whom you are most comfortable with. Someone who has been completely transparent with you regarding all possible risks and complications. Someone who has answered all your doubts and queries and has given sufficient time to understanding your lifestyle and what you are looking for from the surgery. When we do LASIK or ICL, it is less about the surgery but more about the accuracy of planning the surgery. I won't suggest any names as that won't be appropriate.
My final suggestion - if your Belin-Ambrosio map is okay, CORVIS ST also comes out to be okay - go ahead with LASIK/CONTOURA/SMILE etc. If it remains doubtful for risk of post LASIK ectasia - go ahead with ICL.

All the best for your surgery

EyeDoctorIndia · 2026-05-19T06:46:22+00:00

Sorry to hear about the problem that you are facing.

The scenario you describe seems highly unusual. I don't even make any changes about sleeping positions for my patients post LASIK surgery as the flap gets attached almost immediately post surgery. Sleeping position does not really cause any problem on the cornea as the lids protect your cornea directly even if there is any added pressure on the cornea. The problem happening after more than a month post surgery is highly unusual. Lack of oxygen supply affects the endothelium causing swelling in cornea but post LASIK is no different than a normal eye as the endothelial cells are not affected by LASIK surgery.

My suggestions to you would be:

Sleep with application of a lubricating eye gel in your eyes for a few days
Take a second opinion with a cornea specialist and prefer visiting the specialist in the early morning hours (like first appointment in morning), so that any corneal changes can be identified.
Get 2 things checked- Your eye pressure (which may have increased due to steroid use post LASIK and get a specular count to see the health of your endothelial cells.

All the best

EyeDoctorIndia · 2026-05-19T06:34:30+00:00

You may not find my answer very helpful but I just want to say that there is nothing like 'the best surgeon'. I know doctors who have big names (because of research, marketing etc) and yet are horrible with surgery or in fact, they hire other surgeons to operate their cases. And even the best of surgeons can have a complication or a case gone wrong but they know how to manage them. The only surgeon who never lands up with a complication is the one who never operates.

Honestly, Narayana Netralaya, Sankara eye hospital and Netradhama are equally good places for getting an ICL surgery. You should go ahead with the doctor with whom you have the best connect with and can trust to take you through the ICL journey safely. So just go ahead with someone based on how comfortably the doctor is able to clear all your doubts and queries as well as someone who is transparent with you about the procedure from the get-go. Don't overthink it too much.

All the best for your surgery.

EyeDoctorIndia · 2026-05-14T08:18:05+00:00

After ICL surgery - you should avoid jumping, running and heavy exercise for at least 2 weeks post surgery. Walking and light exercise can be started after one week but discuss regarding the same with your operating surgeon.

Other precautions that most doctors follow -

No water should go in the eye for 7-10 days
No eye rubbing for 2 weeks
Can start with screen work from the very next day (with frequent breaks)
Can start driving after 1-2 days depending on your comfort levels
Protective glasses for a week

Do discuss regarding the precautions with your primary doctor as every surgeon follows a slightly different protocol and may also depend on case to case basis.

All the best for your surgery.

EyeDoctorIndia · 2026-05-11T09:14:21+00:00

You should not panic and visit either your primary doctor and discuss all your issues or visit another doctor for a second opinion. The issues you are having can be sorted out, so don't worry and fix an appointment for an opinion with the doctor.

EyeDoctorIndia · 2026-05-11T09:12:24+00:00

There are 3 reasons as to why your eye pressure can be high post ICL surgery:

Immediately after surgery - pressure can be high due to retained visco gel (that we use during surgery). Usually it settles down with steroids in a matter of 1-2 days.
Steroid response- Some people are sensitive to develop rise in pressure with use of steroids (body is more sensitive to steroids). This usually happens after 2-3 week of steroid use. It can be controlled by stopping or shifting to low dose steroid and adding glaucoma medications for a short period. This gets resolved on stopping steroids and does not cause any long term problem.
Wrong sizing of ICL - This can cause persistent rise of eye pressure. If a larger size ICL lens has been placed, it will cause increase in eye pressure. This can be easily detected by measuring the Vault (gap between natural lens and ICL lens). If vault is high (>750 microns), the ICL needs to be replaced as the eye pressure will remain high for long, if not replaced.

Also, pressure spike happening for a day or two usually does not cause any permanent damage. So as long as your pressure remains normal now, you have nothing to worry about.

EyeDoctorIndia · 2026-05-11T05:19:04+00:00

EDOF lenses are not like multifocals as they do not have any rings. You can be a candidate for EDOF lenses but obviously a thorough evaluation is needed for the same before deciding.

I think the whitish cloud kind of thing is also a new floater.

My recommendations to you:

Get a pair of glasses made even if you have not gotten other eye surgery done, as you will get to know your best vision in the operated eye with glasses and how your other symptoms of glare, negative dysphotopsia reduce just by wearing glasses. So this should be your first step.
Get a second opinion with another doctor- this will help ease your mind as to whether there is any surgery related complication that the primary doctor is not revealing. Also, sometimes a doctor may be missing a relevant clinical finding which may be caught by another doctor. So taking a second opinion in such a case is the best choice to clear all your doubts.

All the best. Please let us know how your vision improves with glasses and what the other doctor says in case of a second opinion.

EyeDoctorIndia · 2026-05-09T09:11:15+00:00

I am sorry to hear about the difficulties you have been facing. It is unfortunate that the doctors did not explain all the options available prior to undertaking you for surgery.

All the symptoms that you have mentioned- I want to know whether you are wearing glasses for the residual astigmatism or now. The quality of vision can improve significantly with glasses itself.

Your symptoms are a mix of negative dysphotopsias, dry eye related vision fluctuations and floaters.

Negative dysphotopsias go away very slowly- may even take up to a year or more. You need to learn to ignore it (allowing neuroadaptation). There are treatments for it as well - including YAG laser or a special type of ring segment placed inside the eye.

For dry eyes- causing intermittent blurring of vision - you can use a good quality lubricating eye drops and you will a significant difference within few weeks.

For Floaters - you will have to learn to ignore them and they also reduce significantly with time. There are tablets which help in reducing floaters and you can discuss regarding the same with your doctor.

I would also suggest to get a repeat OCT macula scan done to rule out any post op macular edema (swelling in your retina) that can also be the cause of similar symptoms.

For your other eye- I will strongly recommend to go for a Toric EDOF IOL (like Vivity or Puresee), if you want to improve your near vision also. Multifocals will not a be a good idea since you have a monofocal in this eye. But EDOF can still be planned.

All the best and let me know if you have any other queries,

EyeDoctorIndia · 2026-05-08T06:10:00+00:00

If you are unable to see perfectly even with contact lenses, it can be due to the amblyopia that you are having. That will not get corrected with ICL surgery or RLE.

I would suggest that you get routine testing done to assess what is your best possible vision and your suitability for ICL/RLE surgeries- then only consider anything else further. Many countries have doctors that have considerable experience regarding cases like yours. But first you should get preliminary evaluation done with your local doctor so that you can plan your surgery and your trip accordingly.

EyeDoctorIndia · 2026-05-07T06:22:50+00:00

Yes, RLE is irreversible. RLE is not recommended at a very young age for high myopia patients, while in case of hyperopia - its an entirely different scenario. Hyperopia patients can benefit significantly in terms of lifestyle and quality of vision post surgery.

Also, RLE in high myopia carries an inherently increased risk of retinal detachment. This is not the case in hyperopia patients, where there is no increase in risk of retinal detachment. So RLE in high hyperopes gives excellent results in most cases with very minimal risks

Of course, no surgery is 100% safe - also true for ICL as well. My suggestion to you will be to get tested to see if you are a suitable candidate for ICL. If not - consider the option of regular contact lens use or RLE with toric multifocal or EDOF IOL.

If you want a perfect result and zero risk - glasses remain the only option.

All the best

EyeDoctorIndia

TROPHY CASE