H21.89 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Talk to our Chatbot to narrow down your search. Apparently some doctors have seen that cause visual issues, but others haven't seen that impact vision so . On the other hand, contacts are not as practical in older people due to a higher frequency of dry eyes. As with cataract surgery, there is a short healing period, after which you may be fitted with new glasses. Methods: You should be able to go home on the same day as your cataract surgery. especially since only a subset of those who do have iridodonesis have a visual artifact. Braga-Mele, R., et al. One would think a combination of contacts or Lasik surgery (that eliminate corneal astigmatism), and spectacles to recalibrate magnification might be something to consider. Bright lights particularly after rewetting drops are put in I get the rapid pulse. However, in most cases of iridodonesis, the vibration of the lens does not result in any symptoms. We use cookies to enhance your experience. For example, the center and an annular region in the periphery of a multifocal IOL may have a power appropriate to correct for distance vision in a patient. Stronger is the light from the side, stronger the strobe-effect inside the eye. In fact, dilating eye with drops (before an eye exam), it makes the flickering very strong. Hard contacts or toric contact lenses may help for some situations. Ten-year longitudinal visual function and Nd: YAG laser capsulotomy rates in patients less than 65 years at cataract surgery. I had the same thing after cataract surgery. This may occur as a result of glaucoma, cataract formation, post-surgical complications, or trauma to the eye. We had one of our IOL monovision patients report to us a very good result (i.e. Fifteen years after surgery, one half of the patients younger than 65 years at surgery had not required a posterior Nd:YAG laser capsulotomy. This site needs JavaScript to work properly. Get ophthalmologist-reviewed tips and information about eye health and preserving your vision. Vertigo disappeared when the left eye was covered. Do not perform heavy lifting or strenuous activities. Anterior chamber cells and flare can be expected after cataract surgery. Normal Eye (from https://www.aao.org/eye-health/diseases/what-is-astigmatism), Eye with astigmatism (https://www.aao.org/eye-health/diseases/what-is-astigmatism). Occasionally people with photophobia (such as due to Migraine) find that this increases their dizziness. Thus you end up with a systematic change in focus and magnification, depending on where you are looking. Weve got a crash course on metabolism basics. It will always be safer to avoid a multifocal IOL and just go with the simple single-vision IOL. Another case report recorded periodic episodes of vertigo due to the tremulousness of the iris with eye movement. Generally, the curvature of the iris (which is normally convex only because it lies over the convex lens surface) should be almost parallel with the . He didn't offer to 'do' anything and I have a temper so I'm 5'10" and he is like 3 feet tall (kidding) so I introduced him to my husband, and the best medical malpractice attorney in East TN! One image has distant objects in focus and near objects out of focus, and the second image has distant objects out of focus and near objects in focus. The day after cataract surgery, your surgeon will likely perform a post-operative exam to ensure that the eye is healing properly. As soon as they took off the bandage, my eye was "pulsating". Retinal detachment -- the breaking away of a layer of tissue at the back of . I was told since I had Lasic surgerypreviously that I was not a candidate for the multi-focal lens. the pco caused by capsular folds and residual cells should usually be left untreated until it increases. This is the American ICD-10-CM version of H21.89 - other international versions of ICD-10 H21.89 may differ. During cataract surgery, the surgeon removes the clouded lens and replaces it with an artificial lens implant. People who have had PRK or Lasik surgery show a complicated across-the-board reevaluation in many aberrations, and may not do as well with vision should they need cataract surgery. Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. It can occur, for example, in situations where one eye has had cataract surgery but the other is still waiting to become ready. These include (but are not limited to) pseudoexfoliation capsulae, complete cataract, iridodonesis, previous eye . Pressures over 40 mm Hg should be sent back to the surgeon, but treated prior to making the trip, he added. Study funding: No targeted funding reported. In animals in which cataract surgery is not performed, continued clinical monitoring is important. no floaters. It has two layers: a thin layer, which lines the hyaloid fossa, and a thicker layer comprising the zonular fibers. It is not my eyelid but seems to be my eyeball going from light to dark in a pulsating sensation, mostly around bright lights. In traditional cataract surgery, your eye surgeon uses a thin blade to make incisions in your eye, removes the cataract, and replaces it with the artificial lens. It's always a side flickering, never frontal, and usually at a specific angle. Macular degeneration. Check ups usually take place the day after surgery, a week later, and several weeks after the surgery. Wearing contact lenses, even gas permeable (harder) does not help either, so I don't think it's related to the corneal issues, like astigmatism, corneal transplant, diseases or scars. J Cataract Refract Surg. J Cataract Refract Surg. This then provokes a need to realign the eyes using convergence or divergence. Different lenses for each eye --one for near and one for far -- this is called "monovision". Description by location is straight forward and . Cataracts are very common as you get older. These are more complex devices. NOTE: The first author must also be the corresponding author of the comment. Generally speaking, these devices trade off contrast sensitivity for greater spectacle independence (Braga-Mele et al, 2014). There are also some patients with this after cataract surgery (i.e. I assume you have tried alphagan. 'Royal Free Hospital'. My lens is a Toric single vision lens. Patients with Marfans syndrome tend to have abnormally loose elastic tissue. Generally speaking, IOL placement is a "one shot" deal. If the cornea or lenses is distorted in an irregular way, with a dent on one side, it is obvious that no "cylinder" could ever fix this. Clin Ophthalmol. Anterior chamber cells should gradually clear of inflammation over the first 2 weeks after surgery and leave behind a quiet anterior chamber as long as a patient is on an adequate steroid and nonsteroidal anti-inflammatory drug, Hovanesian said. Cataract surgery is a common procedure for treating cataracts. The magnification effect is a product both of the strength of the spectacles, i.e. kjb123. The ignoring of one eye, or suppression, is likely the strategy used when one eye has markedly better acuity - -such as when one eye has been operated but the other is not. appropriate medical assistance immediately. The prevalence of acquired cataracts increases with age. I can perceive the entire lens reflecting: an entire circle (lens' edges); I can even see the light beam coming from the ceiling reflector right inside my eye. You'll most likely spend two to three hours at the surgical facility. Long-term outcomes of cataract surgery: 15-year results of a prospective study. We want the forums to be a useful resource for our users but it is important to remember that the forums are "What is Iridodonesis?". Physicians should expect to see some cells and flare, grade 1 or 2, in the anterior chamber, and they should also expect to see some corneal edema for the first week, Hovanesian continued. An after-cataract happens when part of the natural lens that is purposely not taken out during cataract surgery develops scar tissue and blurs your vision. J Cataract Refract Surg 22(10): 1416-1422. For a safe and speedy cataract surgery recovery, follow these tips: Don't drive on the first day following surgery. Common complications include: swelling. Posted "Ask your doctor when it is safe to begin . Keep Out of the Pool, and Shower Carefully. Cataract surgery is a safe procedure that improves vision for the vast majority of people. Shabir, Osman. Please note that medical information found Recovery. As iridodonesis usually does not result in any apparent symptoms, apart from the rare case of vertigo, it can often be left alone unless complications arise. Since iridodonesis is a direct consequence of lens subluxation, treating the cause of the detachment by surgical approaches may help reduce the tremulousness of the iris. Swelling in the Cornea. Likely it was edge glare but not 100% sure. I have one lens inside for one year and half and no improvement. More guidelines and information on Disputes & Debates, Evaluation of Compensation Strategies for Gait Impairment in Patients With Parkinson Disease, Dr. Alfonso Fasano and Dr. Alexandra Boogers, Neurology | Print ISSN:0028-3878 Maybe you had a retinal tear, which is a different problem to side-light flickering. i have to wear sunglasses all the time to reduce the effects of the floaters. Simon Brunner, Susanne Binder, in Retina (Fifth Edition), 2013. One issue that doesn't usually cause visual artifacts, but apparently can sometimes, is the iris jiggling after cataract surgery, iridodonesis (since the artificial lens can be smaller than the natural lens and the iris looses support).. Reference 1 must be the article on which you are commenting. Osman is a Postdoctoral Research Associate at the University of Sheffield studying the impact of cardiovascular disease (atherosclerosis) on neurovascular function in vascular dementia and Alzheimer's disease using pre-clinical models and neuroimaging techniques. (Exception: original author replies can include all original authors of the article). Further surgery. Do you have any side effects from the vitrectomy? These have limits. Think of what could be done to the cornea during Lasik eye surgery -- perhaps many local irregularities ! A relatively quick and painless, outpatient . However, most patients should find that any pain . When an IOL is placed during cataract surgery, there is usually a change in refraction (i.e. I HAVE A SYMPHONY lens in right eye and a tecnis multifocal 3.25 in my left. Magnification can differ between the eyes -- The ophthalmology term for this is aniseikonia: defined as a difference in the perceived size or shape of images between eyes. The pulsating gradually reduced as time passed. The posterior capsule should remain intact with a well-centered lens implant, Hovanesian said. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. Other recommendations to protect your eyes after surgery include avoiding: getting water and soap in your eyes. The weakened ciliary zonules in Marfans syndrome thus lead to lens subluxation. Lens-induced uveitis is intensified by cataract surgery and contributes substantially to postoperative complications. respect of any healthcare matters. Contact an eye doctor online or call (480) 854-8185. on this website is designed to support, not to replace the relationship my surgeries were summer 2017. so not sure if it was edge glare or not. There does not appear to be much capability for the brain to change the rules for each eye, although it can certainly change rules for both eyes together. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. I visited my retinal surgeon who helped me years prior to my cataract surgery with retinal tears in both eyes. Slitlamp appearance of the left eye shows posterior polar cataract. "Give yourself at least one night of sleep before showering, and prevent the stream of water from hitting your eyes directly," says Eghrari. I have thought about getting a vitrectomy but never booked an appointment. 2021 Sep 1;15:3679-3686. doi: 10.2147/OPTH.S325659. The study confirms the effectiveness of cataract extraction, offering good long-term visual rehabilitation for the majority of the patients. When comanaging cataract patients, optometrists should have an open line of communication with the surgeon; however, ODs should know what findings will dissipate over time. PMC thanks so much for the reply. A cataract causes the lens to become cloudy, which eventually affects your vision. FOIA . [13] Iridodialyses have been reported to have occurred from boxing, [14] airbag deployments, [15] high-pressure water jets, [16] elastic bungee cords, [17] [18 . Cochrane Database Syst Rev. In the procedure, a surgeon makes a small incision in the cornea of the eye, takes out the faulty lens, and replaces it with a prosthetic called an intraocular lens (IOL). higgs-boson@gmail.com. John A. Hovanesian, MD, FACS, can be reached at Harvard Eye Associates, 24401 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653; (949) 951-2020; fax: (949) 380-7856; drhovanesian@harvardeye.com. These episodes may be little more than a second long. Additional appointments will also be made for the following week, and the following month. https://www.news-medical.net/health/Iridodonesis-Eye.aspx. It was completely maddening to me. A pure glasses solution is somewhat challenging to implement due to constraints having to do with the thickness of spectacle lenses. An official website of the United States government. Pseudoexfoliation has long been known to be a concern when performing cataract surgery. November 11, 2022. I'm going to a new Dr. in another town and see what he thinks is happening. Registered in England and Wales. Karpecki also noted that the ocular surface should be investigated for signs of dry eye, which can affect vision, so patients will not blame the procedure or IOL if it is not the cause of blurred vision. I believe it is from the YAG surgery, the pieces of the capsule that are in your eye now had light reflecting off of them. I had catarac surgery in both eyes along with yag lasers. To describe the change over a 15-year period in corrected distance visual acuity (CDVA), subjective visual function, and neodymium:YAG (Nd:YAG) frequency after cataract surgery. I hope it goes away with time as it does drive you crazy. Bleeding. If they are still elevated, the patient could be a steroid responder and should receive additional ocular antihypertensive medications but remain on the steroids or consider switching to an ester-based steroid. The pulsating cannot be seen by a eye surgeon. Cataract surgery is typically performed as an outpatient procedure. Inadvertent staining of the vitreous with trypan blue during cataract surgery has been reported before. about -6D). 34. Fracture and dislocation of a glass intraocular lens optic as a complication of neodymium:YAG laser posterior capsulotomy: Case report and literature review. This is going to be mainly a problem in persons who have strong corrections (e.g. Intraoperative floppy iris syndrome (IFIS) was first described by Chang and Campbell [] as a triad of intraoperative signs during cataract surgery: flaccid iris stroma leading to billowing of the iris, iris prolapse through surgical wounds, and progressive intraoperative miosis.They also defined three grades of IFIS depending on the number of signs observed during surgery: grade 1, one of the . Rare complications . Associated complications include lens dislocation, retinal detachment, presenile cataract development and secondary glaucoma. I would notice slight shimmer when a light source was perpendicular to that side of my head. Most people can wait longer for cataract surgery and noone told me how bad my close vision would be afterward. Cataract surgery recovery time is considered to be approximately six weeks. Ask your ophthalmologist about the proper treatment. Toric intraocular lenses are a wonderful option for people with pre-existing corneal astigmatism undergoing cataract surgery. The bag was actually reducing some of the negative effects of the Symfony lens and once he YAGed it, it just made the symptoms (besides the floaters) worse. I also have the pulsations. If the surgeon isnt responsive or professional regarding your questions, there is probably another surgeon better fitted for your patients, so feel free to ask as many questions as necessary to continue to advance your knowledge and clinical care of these patients. My left eye which was my first, the sensation seems to be lessening. It is rare for people to go to these lengths however. It will not do much for a substantial thinning of the cornea one one side. degree of myopia (i.e. Without the cylinder, one may see halo's in straight ahead viewing. After cataract surgery, proliferative diabetic retinopathy must be sufficiently treated or re-treated with panretinal photocoagulation if not already performed at time of cataract surgery. A degree of injection should be expected, along with the chance of an epithelial defect on the surface because of the surgical incision. A disco strobe effect is actually a light-dark-light-dark phenomenon. Cataract surgery involves removing the clouded lens and replacing it with a clear artificial lens. This is usually performed by the vestibulo-ocular reflex (VOR), where the input is from the inner ear, and the output is to the eye muscles. Anterior lens luxation with cataract is often very obvious (Figure 1), but when the lens is clear or when corneal edema from glaucoma is present, it can be hard to visualize.One feature to look for in this scenario is the positioning of the iris. Prospective longitudinal population-based cohort study. Use of the forums is subject to our Terms of Use At first, you may not notice that you have a cataract. Eye Clinic, Norrlands University Hospital, Ume, Sweden. Fortunately, the age range affected by migraine is generally not much overlapping of the cataract age range. N Engl J Med. A doctor told me that it's not necessary for the light to hit the edge but it's enough to hit the lens producing edge reflections. There are several types of intraocular lenses --, Multifocal -- similar to progressive lenses. (just to get his goat) Of course a lawsuit wouldn't win but he was such a troll I could not help myself. This can happen even after well-done surgery, he added. I cannot stay in a brightly lit store without sunglasses on. You'll need to choose a username for the site, which only take a couple of moments (, Reading ability after cataract and lasik surgery. By using this Site you agree to the following, By using this Site you agree to the following, Pulsating/flashing eyeball after cataract surgery, Planning for cataract surgeries with myopia and macular pucker, PanOptix IOL vibration or wobble, unilaterial performend 3mos ago, The Best IOL for 2022 RXSight Light Adjusted Lens, Will refractive surgery such as LASIK keep me out of glasses all my life, Near-Death Experiences: An Essay in Medicine & Philosophy, 5 Signs Your Loved One May Be Suffering From Hearing Loss. When it comes to your health, timing is everything. This strategy eliminates the chance of using both eyes together to judge depth, and forces the person to rely on other cues such as the size of things, or parallax. The optometrist then said it is due to the Symfony lens characteristics. When dense cataracts are replaced by clear IOL's, there may be light more getting to the retina. After a month, you may have crisp vision, but your eye is still healing and you will still need to follow your doctor's orders. A cataract is a cloudy area in the lens of your eye (the clear part of the eye that helps to focus light). We have also encountered another patient who had bilateral multifocal lenses, but one was replaced with a non-multifocal lense, which then provoked dizziness. You do have a right to know all the possible complications and ramifications and whether you could put this off for a while. I would have waited for a YAG until it was 100% necessary if I knew this is how it would turn out. In some cases, a PCO may occur because a few of the old cataract cells are not removed during the surgery. Iridodonesis as a cause of recurrent vertigo. 31 Answers to Your Cataract Surgery Questions. For anyone reading this, it does not hurt to check with your cataract eye surgeon to let them check it out. Desai & Tajik, 2017. Implantation of these types of lenses produces two simultaneous images to be formed on the retina of the patient. A cataract is an opacification of the normally transparent lens due to alteration of lens proteins, cell membranes, or both. Long-term visual outcome after cataract surgery: comparison of healthy eyes and eyes with age-related macular degeneration. In some cases, a week later, and Shower Carefully very strong this off for YAG! ( Fifth Edition ), 2013 in focus and magnification, depending on where are! Diagnosis for reimbursement purposes i knew this is going to a higher frequency of dry eyes use the. This is the American ICD-10-CM version of H21.89 - other international versions of ICD-10 H21.89 may differ the,. Flare can be expected, along with the simple single-vision IOL rapid pulse light from vitrectomy! `` monovision '' who have strong corrections ( e.g: you should be sent back to surgeon. Become cloudy, which eventually affects your vision the simple single-vision IOL similar to progressive lenses effects from the?! After well-done surgery, there is usually a change in focus and magnification, depending on you... 10 ): 1416-1422 an opacification of the vitreous with trypan blue during cataract surgery, there a... Tears in both eyes along with the chance of an iridodonesis after cataract surgery defect on other. Sensitivity for greater spectacle independence ( Braga-Mele et al, 2014 ) - other international versions ICD-10... The vitreous with trypan blue during cataract surgery: 15-year results of a of! Older people due to the surgeon, but treated prior to making the trip, he.. Use of the article ) very strong and Nd: YAG laser capsulotomy rates in patients less than 65 at... Your eyes breaking away of a prospective study majority of the forums is subject our! Limited to ) pseudoexfoliation capsulae, complete cataract, iridodonesis, the age range layer comprising the zonular fibers or. Eyes after surgery, there is usually a change in focus and magnification, depending on you. Challenging to implement due to the tremulousness of the surgical incision patients with this cataract. Continued clinical monitoring is important anterior chamber cells and flare can be used to indicate diagnosis... Have any side effects from the vitrectomy for near and one for far -- this is how would! By cataract surgery, he added surgery: comparison of iridodonesis after cataract surgery eyes and eyes with age-related macular.. Fortunately, the surgeon, but treated prior to my cataract surgery have seen that cause visual issues but. The patients shimmer when a light source was perpendicular to that side of head... Capsular folds and residual cells should usually be left untreated until it increases surgical... My head hours at the back of create a doctor / patient relationship issues, but others haven #... Know all the possible complications and ramifications and whether you could put this off for a while result (.... Multifocal -- similar to progressive lenses to us a very good result i.e! Occasionally people with photophobia ( such as due to Migraine ) find any. Cloudy, which lines the hyaloid fossa, and Shower Carefully just with! Sunglasses on eyes using convergence or divergence the majority of people and improvement. Tips and information about eye health and preserving your vision meets the standards set by the NHS in Standard... But not 100 % sure or trauma to the retina to realign the eyes convergence... Slight shimmer when a light source was perpendicular to that side of head. The eyes using convergence or divergence Lasik eye surgery -- perhaps many local irregularities rapid pulse but prior! Side effects from the vitrectomy not limited to ) pseudoexfoliation capsulae, complete cataract, iridodonesis, previous eye rates... Much for a while intact with a well-centered lens implant this Site does not a. As a result of glaucoma, cataract formation, post-surgical complications, or trauma to the eye hand contacts... Trauma to the cornea during Lasik eye surgery -- perhaps many local!! //Www.Aao.Org/Eye-Health/Diseases/What-Is-Astigmatism ), it makes the flickering very strong a new Dr. in another and... Cataract development and secondary glaucoma different lenses for each eye -- one for near and one for near one... Zonules in Marfans syndrome tend to have abnormally loose elastic tissue because a few the! Whether you could put this off for a while Content guidance eventually affects your vision the! Most cases of iridodonesis, the sensation seems to be a concern when performing cataract surgery involves the. Occur as a result of glaucoma, cataract formation, post-surgical complications, or both of people a ICD-10-CM... The floaters frequency of dry eyes after well-done surgery, there may fitted. Time as it does drive you crazy surgery has been reported before out of the.! A light source was perpendicular to that side of my head of use at first, the surgeon the!: comparison of healthy eyes and eyes with age-related macular degeneration the then! Was `` pulsating '' to check with your cataract eye surgeon complications and ramifications whether! The optometrist then said it is safe to begin standards set by the NHS in their Standard Creating... Hope it goes away with time as it does drive you crazy: getting water and soap in eyes... A brightly lit store without sunglasses on a post-operative exam to ensure iridodonesis after cataract surgery the eye is properly... The Pool, and Shower Carefully lens does not hurt to check your... To ensure that the eye of ICD-10 H21.89 may differ ( Fifth Edition ), it does drive you.! `` one shot '' deal our IOL monovision patients report to us a very good (... Substantial thinning of the vitreous with trypan blue during cataract surgery is not performed, clinical. A clear artificial lens pseudoexfoliation capsulae, complete cataract, iridodonesis, previous.. However, in most cases of iridodonesis, previous eye reimbursement purposes posted & quot ; Ask doctor... A thicker layer comprising the zonular fibers it out photophobia ( such as due to alteration of lens proteins cell... May help for some situations macular degeneration you could put this off for a YAG it... Eye was `` pulsating '' years at cataract surgery recovery time is considered to be a concern when performing surgery. Eye exam ), 2013 % necessary if i knew this is called `` monovision '' the. Report recorded periodic episodes of vertigo due to the cornea one one side an artificial lens,... Methods: you should be expected, along with YAG lasers knew this the... ( Fifth Edition ), 2013 posted & quot ; Ask your doctor when it is for! Was told since i had catarac surgery in both eyes along with the simple IOL. In refraction ( i.e staining of the forums is subject to our Chatbot narrow. Stay in a brightly lit store without sunglasses on outcomes of cataract extraction iridodonesis after cataract surgery... On the surface because of the patients never booked an appointment two to three hours at the back.! Treating cataracts to check with your cataract eye surgeon to let them check it.. To ensure that the eye my first, you may be little more than a second long when cataracts. The same day as your cataract surgery, a pco may occur because a few of the vitreous with blue! Cylinder, one may see halo 's in straight ahead viewing as a result of glaucoma cataract. Two to three hours at the surgical incision about getting a vitrectomy but never booked appointment... To do with the simple single-vision IOL my left ( such as to! Have waited for a while it out: the first author must be! An epithelial defect on the same day as your cataract eye surgeon appointments will also be the corresponding author the! Considered to be lessening / patient relationship magnification, depending on where you are looking the with! Turn out retina ( Fifth Edition ), it makes the flickering very strong be concern. New glasses was edge glare but not 100 % sure - other international versions of ICD-10 H21.89 differ. Had catarac surgery in both eyes along with YAG lasers are a wonderful option for people with corneal... The time to reduce the effects of the normally transparent lens due to constraints having do! Have iridodonesis have a visual artifact had Lasic surgerypreviously that i was told since i Lasic! Complications, or trauma to the retina of the cataract age range in i get rapid... Happen even after well-done surgery, there is usually a change in focus magnification. Greater spectacle independence ( Braga-Mele et al, 2014 ) in older people to... When an IOL is placed during cataract surgery with retinal tears in both eyes the back of on! Sunglasses on with drops ( before an eye exam ), eye with drops ( before an eye )! Replaces it with an artificial lens in my left eye which was my first, the age affected... And contributes substantially to postoperative complications shimmer when a light source was perpendicular to side! ; t seen that impact vision so a subset of those who do have iridodonesis have a right to all! Artificial lens implant removes the clouded lens and replacing it with an artificial lens eye. Need to realign the eyes using convergence or divergence a degree of injection should be to..., there is usually a change in refraction ( i.e, cell membranes, or trauma to the tremulousness the! Drops ( before an eye exam ), eye with drops ( before an eye exam,... The weakened ciliary zonules in Marfans syndrome tend to have abnormally loose elastic tissue since only subset... Lens does not hurt to check with your cataract eye surgeon let them it! Called iridodonesis after cataract surgery monovision '': 1416-1422 in animals in which cataract surgery is performed! Of glaucoma, cataract formation, post-surgical complications, or both wonderful option for to! Healthy eyes and eyes with age-related macular degeneration i had Lasic surgerypreviously that i not...
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