cataract surgery on both eyes separated by one week

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
glasses?

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.

Myrna

 

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.

 

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
work?

 

Forget to add that there is +2.5 at the end of each string of numbers.

 

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.

 

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?

--
Cheers,
Bev
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
"History I believe furnishes no example of a priest-ridden people
maintaining a free civil government."
-- letter from Thomas Jefferson to Baron vonHumboldt, 1813

 

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

DrG

 

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.

 

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.

 

Oops, make that "less dense"

 

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.

DrG

 

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.

 

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.

DrG

 

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

 

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.

 

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.

 

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
not.

DrG

 

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.

 

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.

 

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.