cataract surgery on both eyes separated by one week

Discussion in 'Laser Eye Surgery' started by myrnapap, May 20, 2005.

  1. myrnapap

    myrnapap Guest

    I'm hoping you can help me figure out how things will work for me. I
    will be having cataract surgery on both eyes with one week between. I
    am quite nearsigted and have a lot of asigmatism. I currently wear
    progressive lenses.

    Once the first eye is done, I'm assuming that I won't be able to see
    clearly out of eyeglass on that side. I can't imagine how I will
    manage. I will have somewhat better vision in that eye but the
    astigmatism will still be there. Will we remove the lense from my

    One week later, I'm guessing I will have the same problem with the
    second lense. While most folks return to normal activity a few days
    after surgery I'm wondering if I will be able to drive, read, and
    function since I don't think I can have new glasses for a while.

    If anyone can ease my mind on this whole thing, I'd appreciate it.

    myrnapap, May 20, 2005
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  2. It could be helpful if you post the numbers of your Rx.
    That can done, even though it looks wierd. Depending on how much better
    the operated eye sees than the other, you may prefer to just go without
    (plan on picking up some OTC readers)
    Right. At that point you can discard both old lenses and use OTC
    readers. It's a snap. I know, I've been there.

    w.stacy, o.d.
    William Stacy, May 20, 2005
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  3. myrnapap

    myrnapap Guest

    Here are the numbers:

    OD 6.50- 2.25,x061 and OS 4.50 - 2,25 x 121

    The better eye is being done first. I'm not sure how I can go without
    the corrective lens on the second eye. And will I be able to drive to
    myrnapap, May 20, 2005
  4. myrnapap

    myrnapap Guest

    Forget to add that there is +2.5 at the end of each string of numbers.
    myrnapap, May 20, 2005
  5. Since your first post said you're nearsighted, I'll assume the "OD 6.50"
    and the "OS 4.50" had minus signs before the numeric portion...

    Either way, I'll also assume the better eye is the left eye (unless it
    has a worse cataract, in which case it might be the worse eye.

    Whatever, you will probably have a problem, and I have no real way of
    knowing which is going to be your best situation. I suggest you wait to
    do anything until the day after surgery. At that point, if your old
    glasses seem not too bad as is, just wear them. If it's better without
    them than with them, I'd remove the lens from the operative side and see
    how things look to you. If this is intolerable, just go without glasses
    (except for the otc readers as needed). Good luck.

    w.stacy, o.d.
    William Stacy, May 20, 2005
  6. myrnapap

    The Real Bev Guest

    Why would they do the better eye first? That doesn't sound right -- if
    something nasty happens (unlikely, but still...) it would be better if it
    happened to your worse eye, right?

    "History I believe furnishes no example of a priest-ridden people
    maintaining a free civil government."
    -- letter from Thomas Jefferson to Baron vonHumboldt, 1813
    The Real Bev, May 21, 2005
  7. myrnapap

    Dr. Leukoma Guest

    Not only that, but I thought it was more common to wait a bit longer
    between the two surgeries.

    Dr. Leukoma, May 21, 2005
  8. I only waited 1 week, and appreciated only having one week of
    significant anisometropia. With small, self-sealing incisions and
    no-injection anesthetic, there is no reason to wait. My vision has been
    very stable since day 1 post-op, and there is no restriction in
    activity, unlike LASIK. That's why I now recommend lens exchanges (by
    the right surgeon) for all presbyopic hyperopes (plus relaxing incision
    for those with significant astigmatism) who desire refractive surgery.

    w.stacy, o.d.
    William Stacy, May 21, 2005
  9. It isn't clear what she meant by "better". It could be the less myopic
    eye, but it could mean the more myopic eye if the cataract were more
    dense in that eye. It also could mean that there is another unmentioned
    defect in the "worse" eye. That said, I don't think it's a big deal,
    but yes, the "norm" is to do the more cataractous eye first, all other
    things being equal.
    William Stacy, May 21, 2005
  10. Oops, make that "less dense"
    William Stacy, May 21, 2005
  11. myrnapap

    Dr. Leukoma Guest

    I think it depends on the surgeon. When my mother had hers done, the
    surgeon wanted to wait four weeks just in case of some complication
    like steroid glaucoma or CME.

    Dr. Leukoma, May 21, 2005
  12. It *definitely* depends on the surgeon. You probably won't find studies
    on this, but the truth is, the better the surgeon, the lower the
    complication rate. It is just common sense that the less time the eye
    is open and the smaller the incision, the fewer the complications, all
    things being equal. So you get a glaucoma or cme, does that mean he
    won't do the other eye? I suppose it might mean fewer office visits,
    but I think some day they will even do bilateral procedures (like when
    reimbursements are equal to the unilateral ones).

    w.stacy, o.d.
    William Stacy, May 21, 2005
  13. myrnapap

    Dr. Leukoma Guest

    I'm not sure what the skill of the surgeon has to do with the mean time
    between doing cataract surgery on both eyes, or even if that is what
    you were inferring. And, yes, I guess if one eye goes blind, it might
    impact when or how the surgery is performed on the fellow eye.

    Dr. Leukoma, May 21, 2005
  14. I was inferring just that. The amount of trauma the eye receives during
    surgery in inversely proportional to the skill of the surgeon, to the
    time the eye is open, and to the subsequent healing time. No doubt
    about it. As to the blind eye comment, that's a very rare complication
    to uncomplicated lens exchange. Certainly it can happen, but lightning
    rarely strikes the same place twice, unless that place is a very high
    risk place.

    w stacy
    William Stacy, May 21, 2005
  15. myrnapap

    myrnapap Guest

    Some of this discussion is really frightening to me. I was concerned
    when the doctor said he wanted to do the left eye first since this eye
    is a little less myopic than the right eye. I don't remember which
    cataract is worse but I think it's the right eye. His reason is that I
    am right handed and very right sided with everything I do. I don't know
    the correct word for that but he seems to think it's better to do the
    left eye since I tend to rely more on the right eye. I've been very
    concerned because if something does go wrong then I'm left with the eye
    with the least vision.
    myrnapap, May 21, 2005
  16. myrnapap

    myrnapap Guest

    I forgot to clarify why I'm doing this one week apart rather than two.
    There are two reasons. We first tried to schedule two weeks apart but
    with the doc's schedule, mine, and my husband, there were no other
    options. Also, there was some suggestion that I will see double since
    the operated eye will have some much less myopia than the other eye and
    this will minimize that problem. I'm still really feeling scared about
    all of this.
    myrnapap, May 21, 2005
  17. myrnapap

    Dr. Leukoma Guest

    Are you indeed myopic? I don't recall seeing a negative sign in front
    of the first number. Anyhow, that is a moot point, since your surgeon
    could just as easily calculate the power of the IOL to leave you
    myopic/hyperopic so that you wouldn't have double vision. However, in
    the case that you were given an IOL that gave you "double vision," you
    can always simply patch the other eye.

    I am sorry if you are feeling scared, but in a way I am feeling
    "put-upon" for spending the time in consultation with you when your
    surgeon should be doing it. After all, he/she is getting paid and I am

    Dr. Leukoma, May 21, 2005
  18. Bull shit. Your doc is just trying to appease you. It really doesn't
    matter which eye is done first, assuming you have a competent surgeon.
    You will be up and running the next day. If he is not competent, fire
    him and try another doc. Case closed.

    w.stacy, o.d.
    William Stacy, May 22, 2005
  19. Make sure he is doing small incision (about 3 mm) and stichless. If
    not, fire him and hire a new doc who is up to snuff. Sorry to be so
    abrasive, but I'm tired of hearing these weak excuses from these guys.

    w.stacy, o.d.
    William Stacy, May 22, 2005
  20. What the hell? Whether she is myopic or hyperopic around 6 diopters,
    she's sure as hell going to have diplopia following the first procedure.
    I don't think it's a big deal, I mean it's only for a week, but to say
    that the surgeon can easily calculate it so that she won't have diplopia
    is crazy. Crazy.

    However, in
    OK wierd, but ok.
    Damn. Get off the internet if you're feeling put upon. Damn.

    w.stacy, o.d.
    William Stacy, May 22, 2005
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