Cataract Surgery After Effects And IOL Question

Discussion in 'Laser Eye Surgery' started by George, Jun 22, 2005.

  1. George

    George Guest

    Hello all,

    Just had cataract surgery yesterday on right eye. Left eye was done 3
    years ago with moderate success. Still some glare but I am plano in
    that one.

    Removed patch on right eye and, after 6 six hours, and saw a red glow in
    center of field of view. Also double image of bright objects. Did not
    have these "effects" after the first surgery. Any comments?

    On a technical note, I had a SA60AT, 16.0 IOL placed in left eye 3 years
    ago. Laser tests for that eye showed that using Halliday formula, an
    IOL(D) 15.5 would produce REF(D) of 0.01, while an IOL(D) of 16.0 would
    produce a REF(D) of -0.34. (The Emme. IOP: was 15.51). Surgeon chose
    the 16.0 instead of 15.5. Why? Surgeon's choice seems to be okay since
    I am plano with standard eye test.

    Now for the right eye done yesterday, laser tested IOL(D) 15.0 produces
    REF(D) -0.03 and IOL(D)15.5 produces REF(D) -0.38. (Emme. IOL: 14.96)
    He chose to use a SA60AT 15.0 IOL. Why? If he followed same rule as in
    above left eye, wouldn't he chose a IOL of 15.5 ??

    Just a curious professor looking to understand the concept a little
    better.

    George
     
    George, Jun 22, 2005
    #1
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  2. Don't know about the red glow; could be a little macular edema. The
    surgeon want's to err a little on the side of myopia, which is a good
    thing, rather than leave you hyperopic. There is a margin of error to
    those measurements, so the approach is one that worked perfectly on the
    first eye, that is, if he'd chosen the emmetropic value, you'd now be
    hyperopic (not perfectly clear at ANY distance without glasses).

    w.stacy, o.d.
     
    William Stacy, Jun 22, 2005
    #2
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  3. George

    George Guest

    William Stacy wrote:

    "Don't know about the red glow; could be a little macular edema. The
    surgeon want's to err a little on the side of myopia, which is a good
    thing, rather than leave you hyperopic. There is a margin of error to
    those measurements, so the approach is one that worked perfectly on the
    first eye, that is, if he'd chosen the emmetropic value, you'd now be
    hyperopic (not perfectly clear at ANY distance without glasses).

    w.stacy, o.d."

    Hello William,

    I realize there is a margin of error to these measurements, but if he chose to
    make the left eye slightly myopic, why didn't he choose the IOL(D)15.5, Ref(D)
    -0.38 to also make the right eye slightly myopic? Seems like same margin of
    error to me as left eye.

    George

    "George wrote:
    Hello all,

    Just had cataract surgery yesterday on right eye. Left eye was done 3
    years ago with moderate success. Still some glare but I am plano in
    that one.

    Removed patch on right eye and, after 6 six hours, and saw a red glow in
    center of field of view. Also double image of bright objects. Did not
    have these "effects" after the first surgery. Any comments?

    On a technical note, I had a SA60AT, 16.0 IOL placed in left eye 3 years
    ago. Laser tests for that eye showed that using Halliday formula, an
    IOL(D) 15.5 would produce REF(D) of 0.01, while an IOL(D) of 16.0 would
    produce a REF(D) of -0.34. (The Emme. IOP: was 15.51). Surgeon chose
    the 16.0 instead of 15.5. Why? Surgeon's choice seems to be okay since
    I am plano with standard eye test.

    Now for the right eye done yesterday, laser tested IOL(D) 15.0 produces
    REF(D) -0.03 and IOL(D)15.5 produces REF(D) -0.38. (Emme. IOL: 14.96)
    He chose to use a SA60AT 15.0 IOL. Why? If he followed same rule as in
    above left eye, wouldn't he chose a IOL of 15.5 ??

    Just a curious professor looking to understand the concept a little
    better.

    George"
     
    George, Jun 22, 2005
    #3
  4. You're quite right, he's shooting for zero refraction. Hopefully that's
    what you got. May be more to the story than you or I know. Let us know
    how it turned out.

    w.stacy, o.d.
     
    William Stacy, Jun 22, 2005
    #4
  5. George

    George Guest

    Talked to surgeon today, for 1 day post op exam, and asked him about this choice of
    IOL. He said that he has now more confidence in the eye measurements today than
    three years ago so decided to go for zero refraction. (Both eyes were measured 3
    years ago on a laser setup). He also said that there probably wouldn't be much or
    any difference in my vision even with the 15.5 instead of the 15.0 IOL that was
    used. Standard vision test given to me by his lab assistant showed 20/20 for the new
    eye, so it worked out okay. I would have preferred the 15.5 lens and be slightly
    myopic, but its done now and I'm not changing it out at this point in life... I'm 66
    years old. He said most patients could care less about this level of detail and
    just want it done (the surgery) and to go home seeing better. But, he said,
    professionals (in particular professors) generally are more picky and want to know
    more of whats involved and possible choices..

    Regarding the red glow he said not to worry as it will disspate in a few days.

    George

    William Stacy wrote..........

    "You're quite right, he's shooting for zero refraction. Hopefully that's
    what you got. May be more to the story than you or I know. Let us know
    how it turned out."

    w.stacy, o.d.

    George wrote:

    William Stacy wrote:

    "Don't know about the red glow; could be a little macular edema. The
    surgeon want's to err a little on the side of myopia, which is a good
    thing, rather than leave you hyperopic. There is a margin of error to
    those measurements, so the approach is one that worked perfectly on the
    first eye, that is, if he'd chosen the emmetropic value, you'd now be
    hyperopic (not perfectly clear at ANY distance without glasses).

    w.stacy, o.d."

    Hello William,

    I realize there is a margin of error to these measurements, but if he chose to
    make the left eye slightly myopic, why didn't he choose the IOL(D)15.5, Ref(D)
    -0.38 to also make the right eye slightly myopic? Seems like same margin of
    error to me as left eye.

    George
     
    George, Jun 23, 2005
    #5
  6. I know what you mean, but you'll do fine. I ended up 0.00 in one eye
    and about -.75 in the other and like it for lots of things, but still
    like that crisp binocularity you get with 0.00 in both eyes, so while I
    don't "need" them, I wear progressives most of the time, and would not
    have minded being 0.00 o.u. I would have been disappointed had I been
    left +.50 or more in either eye.

    w.stacy, o.d.
     
    William Stacy, Jun 23, 2005
    #6
  7. George

    George Guest

    Well its nice to know that someone else ended up like me with slight myopia (-0.4) in one
    eye and 0.0 in the other. It might turn out to be an advantage as now my left eye can see
    slightly better at short range and right eye is crisp at long range. My new HDTV sets's
    picture is excellent too. Don't see a need for glasses (except for computer), and
    definitely will not use progressives again as I could never get the hang of them. The
    frames are nice and I might change the progressive lenses out for computer/reading lenses.

    My only remaining problem is I have major floaters due to vitreous detachment. My surgeon
    goes into a tizzy when I even mention treating them with a laser; Says its too dangerous.
    Since I have not read about any advancements in the laser floater treatment area he is
    probably correct. But its fun to discuss it with him and I think he likes it too since
    many patients won't even bring up things like that <grin>.

    Regards,

    George

    William Stacy wrote:

    ""I know what you mean, but you'll do fine. I ended up 0.00 in one eye
    and about -.75 in the other and like it for lots of things, but still
    like that crisp binocularity you get with 0.00 in both eyes, so while I
    don't "need" them, I wear progressives most of the time, and would not
    have minded being 0.00 o.u. I would have been disappointed had I been
    left +.50 or more in either eye.

    w.stacy, o.d.""

    George wrote:
    "Talked to surgeon today, for 1 day post op exam, and asked him about this choice of
    IOL. He said that he has now more confidence in the eye measurements today than
    three years ago so decided to go for zero refraction. (Both eyes were measured 3 years
    ago on a laser setup). He also said that there probably wouldn't be much or
    any difference in my vision even with the 15.5 instead of the 15.0 IOL that was
    used. Standard vision test given to me by his lab assistant showed 20/20 for the new
    eye, so it worked out okay. I would have preferred the 15.5 lens and be slightly
    myopic, but its done now and I'm not changing it out at this point in life... I'm 66
    years old. He said most patients could care less about this level of detail and
    just want it done (the surgery) and to go home seeing better. But, he said,
    professionals (in particular professors) generally are more picky and want to know
    more of whats involved and possible choices..

    Regarding the red glow he said not to worry as it will disspate in a few days.

    George"

    William Stacy wrote..........

    "You're quite right, he's shooting for zero refraction. Hopefully that's
    what you got. May be more to the story than you or I know. Let us know
    how it turned out."

    w.stacy, o.d.
     
    George, Jun 23, 2005
    #7
  8. George wrote:
    y only remaining problem is I have major floaters due to vitreous
    detachment. My surgeon
    We did end up the same, as I had a VD in one eye with a small hemorrhage
    that has cleared up. The floaters remain, but I'm getting used to them.
    He's right, it would have to be a pretty bad floater to warrant a
    surgical fix, and I think vitrectomy would be preferable to laser at
    that point (I don't much like the idea of little explosions going off in
    my posterior chamber, thank you very much...)

    w.stacy, o.d.
     
    William Stacy, Jun 23, 2005
    #8
  9. George

    George Guest

    Interesting that we ended up the same <g>. Professors are noted for
    near-sightedness because of all the close work we do involving reading and
    looking at computer screens. Unfortunately, VD seems to follow along with
    this symptom. You are probably in same category due to your type of work.
    Some reasons my surgeon gave for not using lasers to smash the floaters are
    that it might just get fractured into many pieces and cloud the vision
    more. Also said, in my case, the floaters were too far in back of eye and
    there might be a chance of hitting the retina with laser. To me, that's a
    serious risk. He described the vitrectomy procedure, and while they have
    professors that do that procedure that at the Eye Institute, it sounded too
    involved and with major risk too. I would not consider it unless I had
    severe blockage from the floater. As it is now I can move my eyes and, most
    of the time find a clear spot to see through. And, as you said, you do get
    used to it.

    George
     
    George, Jun 23, 2005
    #9
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