Cataract Surgery After Effects And IOL Question

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

 

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 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"

 

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.

 

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

 

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.

 

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 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.

 

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