Cataract surgery lens implant problems...help!

Discussion in 'Laser Eye Surgery' started by Rodent, May 21, 2004.

  1. Rodent

    Rodent Guest

    I recently (2 weeks ago) had a cataract removed and a lens implanted in my
    left eye. I was very nearsighted prior to surgery (don't have numbers), a
    line below the big E was about it on eye chart. My vision in implant eye is
    getting better (about 20/40 today I think) however since my right eye is
    still very poor far vision it is very difficult to go without glasses. The
    difference in acuity causes right eye to water,hurt etc. My eye doctor
    instructed me to *not* wear my glasses even though I told him this. Also I
    had to remove (L)lens from eyeglasses since eyeball has it's own lens now
    which has resulted in (close) items in left eye looking about 25% bigger
    than items in right eye. I again told him this and his response was "don't
    wear the glasses". He told me to return in 3 weeks and said goodbye. From
    about 10" to 24" I can't see anything without the damn glasses! I was so
    stunned by his cavaleer attitude I forgot to remind him of this little fact
    (he's been my eye doctor for about 20 years duh!).

    I starting to wonder if he knows what he's doing. I've only had routine
    exams prescriptions until now so he's never been "tested". There are other
    issues like the floater/debris field that moves back and forth, the tiny
    specks that don't move, etc. Anyone have this done, or have any thoughts?

    PS. I'm 46 yrs old
     
    Rodent, May 21, 2004
    #1
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  2. Rodent

    Dan Abel Guest


    Doesn't make sense to me. I keep hearing that glasses can't hurt you, so
    if wearing them is better, why not wear them? When I had my first
    cataract removed, I had them remove the lens in my glasses for that eye
    and wore them until it was time to get a new lens. I usually wore
    contacts then, so just didn't put a contact in that eye until I got new
    contacts for that eye.

    You will probably have difficulty with the different size of the images,
    assuming that they fixed the cataract eye refraction and you are still
    nearsighted in the other eye. This often causes people to see double. I
    was very glad when I got my second eye done because this was also the case
    for me.
     
    Dan Abel, May 22, 2004
    #2
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  3. Rodent

    Orv Guest

    After my first cataract operation two years ago I removed that lens from my
    glasses myself and wore them with little or no problem for over six weeks
    until I got a new refraction filled. Like the orignal poster, I too had a
    very strong correction in the remaining lens and about 20 - 40 in the
    operated eye. When they sent me to the optometrist for the new refraction,
    she added a "slab-off" correction so the two eyes would see the same. I
    understand the slab-off is a prism or sub-lens that handles this problem -
    in my case perfectly. I never could see the slab-off lens in the new
    glasses and in fact don't know if it went into the corrected eye lens or the
    old high correction lens. Two weeks ago I had the other eye operated on for
    a cataract and the opthalmologist ensured not only that the old high
    correction was removed the 2nd day, but that I had a "plain" plastic lens
    inserted as a temporary measure so I wouldn't poke myself in the eye. The
    optometrist made the plain lens in about 15 minutes for $30 dollars and put
    it in. It will stay there for a couple more weeks until I get a new
    refraction and have them sent off for filling.

    Regards
     
    Orv, May 22, 2004
    #3
  4. Rodent

    Rodent Guest

    Thanks for the reply. Nice to know there is a "fix". I mentioned that I had
    read somewhere about a slab or something to my ophthalmologist and his response
    was something like "no you don't want to get into that". Can't understand
    why he is so bent on no glasses. I can't stand having eyes being so different.

    Maybe I should ask for a monocle?

    BTW did you have any "floaters" (cloudy or black debris) after surgery?
     
    Rodent, May 22, 2004
    #4
  5. Rodent

    Dr Judy Guest

    Is the size difference only apparent with the glasses on? Is the watering,
    discomfort etc worse with the glasses on? If so, then his advice on how to
    resolve the size difference was right: don't wear the glasses.

    Unfortunately, until your eye is healed it is not possible to get a reliable
    refraction and a lens that will improve the vision in the left eye. All
    post cataract patients who had significant refractive error pre surgery have
    this problem and nothing can be done about it until 6 to 8 weeks after
    surgery.

    If you have taken the left lens out of your glasses and you feel more
    comfortable with the glasses on, there is no harm in wearing them.

    Dr Judy
    Floaters, flecks, specs etc are not uncommon after surgery. Your doctor is
    checking you and will be looking for serious post surgery effects.
     
    Dr Judy, May 22, 2004
    #5
  6. It is difficuilt to wear a pair of glasses with one eye plano and the other
    eye wearing a strong minus lens. This is due to the difference in image size
    and the prismatic effects as you move your gaze from side to side and up and
    down. if your right va is 20/20 then without the spectacles you are
    depending on the left eye to see. This reduces your va to 20/40 from 20/20.
    Ask to be fitted with a contact lens in your right eye. That should solve
    the problem.

    Roland J. Izaac
    --
     
    Roland J. Izaac, May 23, 2004
    #6
  7. 1. Consult another ophthalmologist.
    2. Suggest to both of them that you try wearing a contact lens in *one* eye
    (probably the non-operated eye) to make the two eyes match. See how they
    respond.
     
    Richard Schumacher, May 23, 2004
    #7
  8. Or a contact lens. Disposables are very comfortable.

    Yes. They are common, and your surgeon should have mentioned them as a
    possibility.
     
    Richard Schumacher, May 23, 2004
    #8
  9. Rodent

    Dan Abel Guest


    My OMD was very good about this. He warned me about possible problems
    some years before the surgery, when cataract was first found. He strongly
    suggested that I try wearing contacts, so I would know what my options
    were well before I needed to make decisions about how I wanted my vision
    to be after the surgery. He suggested wearing them for a year, at which
    time I would know how they worked, and I could decide at that time to stop
    wearing them until I needed to. He also said that many people with my
    eyesight (high myopia) decided to continue wearing contacts after the
    year. I in fact did.
     
    Dan Abel, May 24, 2004
    #9
  10. Rodent

    Rodent Guest

    I do actually have a (very early) cataract in other eye. None of the
    problems I'm having were revieved with me prior to surgery. I'm really
    begining to wonder if my eye doc. is incompetent. He is really pushing
    for no glasses! Even if I do get other eye done I don't know if I
    knowingly would have agreed to giving up my close vision.
     
    Rodent, May 26, 2004
    #10
  11. Rodent

    Dan Abel Guest


    I'm pretty sure that my insurance would not have paid for all of this.
    Since I could see pretty well, waiting for 4-6 weeks wasn't a problem.


    When you have cataract, the choice is to give up part of your vision
    (either close or far, it's your choice) or to give up *all* of your vision
    by not having the surgery. It's gradual, but cataract generally progesses
    over time until you are totally blind.

    You have many choices, and somebody needs to help you explore them. I
    personally wear OTC reading glasses over my contact for close, and the
    contact corrects my astigmatism. I asked the doctor to implant lenses
    that would give me sharp vision at distance, and was lucky enough that
    this happened just great.
     
    Dan Abel, May 26, 2004
    #11
  12. Rodent

    The Real Bev Guest

    I don't know about 'incompetent,' but he seems to be pretty
    paternalistic. My mom's (and mine too, at least until I actually need
    surgery) ophthalmologist just decided for her that she should have near
    vision. She didn't know that a choice was even possible until I found
    out about it here at least 10 years later.
    I suspect that one of the reasons that doctors get sued so frequently is
    that they just don't talk to their patients. It never occurs to some
    people to ask questions, they just feel that 'doctor knows best' and do
    what he says unthinkingly. If something turns out badly it's not just
    an error or an accident, it's a betrayal of trust for which vengeance is
    appropriate.

    I blame the insurance companies -- the docs just can't spend that much
    time talking when they have to book a dozen patients per hour.

    --
    Cheers,
    Bev
    $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
    "One's chances of winning the lottery are not appreciably
    improved by actually buying a ticket."
     
    The Real Bev, May 27, 2004
    #12
  13. Rodent

    John Doe Guest

    Rodent
    My surgery was for 2 cataracts in Feb and March this year. I know what you
    mean about the problem with using glasses afterward. My Dr recommended no
    glasses. I had to work, and made it through the 2 weeks with a contact lens
    which I had given up wearing about a year earlier..
    Glasses gave me such a visual size difference I would have gone nuts!
    I opted for the array multifocal lenses and have been a bit disappointed in
    the results. I still have fairly significant halos around lights and double
    images or ghost images of almost everything. I have been using reading
    glasses too since I have a hard time reading small print. I have to say my
    vision has overall gotten worse in the past 60 days since my closeup vision
    has worsened significantly and the distance vision (while still fairly good)
    has not improved by lessening of the double Ghost images. The astigmatism
    glasses help some, but I hoped to not need glasses after the surgery and am
    now anticipating a lasik procedure to help my close up vision.
    Still very early, but I might even consider going to mono lenses if I could
    get these array lenses removed. I will give it a year or so before I decide
    on that!

    I think I am developing post capsulary (secondary?) cataracts. I am
    starting to have problems seeing things and people when they are backlit.
    That was one of the reasons I had the cataracts removed. I was told the
    younger you are when you have cataracts, the more common it is for the
    secondary cats to develop. I am 43 yrs old. YAG laser should take care of
    the problems. I hope to get answers in a week during my follow-up
    appointment.
    Anyway good luck with your procedures.
     
    John Doe, May 28, 2004
    #13
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