IOL exchange & piggyback lensGold Coast & Tweed Heads

Dr Weaver has a particular interest in helping people whose cataract surgery result is not what they hoped. This includes replacing a lens implant, adding a second lens, and other repeat procedures. His training in retinal surgery is relevant to these more complex operations.

Cataract surgery usually goes well. A small number of people end up with a result that is not ideal. The focus may be off, the lens may have moved or be unstable, or the lens may not suit them. These problems can often be corrected with a second operation.

Common reasons people ask about further surgery:

• Still very short-sighted, long-sighted or astigmatic after surgery
• Unhappy with a multifocal lens because of halos, glare or light effects that badly affect daily life
• The lens has moved out of position
• The lens is tilted or off-centre, causing blurred or distorted vision
• The lens bag has shrunk and is squeezing the lens out of shape
• No lens was put in at the original operation

Replacing a lens means taking out the original lens implant and putting in a new one. In the first few weeks to months after surgery, this is usually fairly straightforward and can be done through a small opening, like the original operation.

Later on, months or years after surgery, the lens becomes stuck inside its bag and is harder to remove. Dr Weaver manages these more complex replacements, including when the back of the lens bag is missing or damaged.

A piggyback lens is a second, thin lens placed in front of the existing lens implant, just behind the iris. It avoids the risks of taking the original lens out, and can correct a focus that is off after cataract surgery. Special lenses are made for this, including ones that also correct astigmatism.

A piggyback lens is especially useful when:

• The focus is well off and glasses do not correct it well
• Laser eye surgery is not suitable, for example because the cornea is thin or the correction needed is large
• The original lens is stable but simply the wrong strength

If there is no lens bag to hold a lens, for example after a complicated operation, an injury or weak support fibres, the new lens is fixed to the white wall of the eye (the sclera). Dr Weaver usually uses this approach, with stitches or the stitch-free method, for eyes without a lens and for lenses that have moved out of place.

Careful planning matters for every repeat lens operation. This includes measuring the eye to work out the right lens strength, mapping the cornea (Pentacam) to check for astigmatism, a scan of the macula (OCT), and reviewing the notes from your first operation. Dr Weaver will talk through your options, likely results and risks at your appointment.