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Medical Forum / General / Vision / May 2005

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Reflections and glare after cataract operation

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Uncle - 04 May 2005 16:48 GMT
My sister had a cataract removed about a month ago by her local
ophthalmologist and the implant lens left her more nearsighted than
she had planned on, probably due to an error in measuring the eye
length. She went to a specialist group in Boston and had the operation
redone within a week. She is now about a minus 1 diopter in that eye,
which was what she wanted, but she is extremely bothered by
reflections and glare from any light sources anywhere at the edges of
her field of vision. This occurs under all conditions, indoors and
outdoors, light or dark. It is not due to dilated pupils. The glare
can  be reduced or eliminated by shading the light source with the
hands or  a visor, depending on the direction of the light. She was
originally about a minus 6. The first operation produced -3.5 with no
glare with an Alcon implant.  In the second operation, an Allergan
lens was used.

She has since been examined by the Boston surgeon, her retina
specialist, and a third ophthalmologist. All say that the lens is
properly positioned, and  her cornea is clear, and can give no reason
for the glare. They all say she will "get used to it."

Could this be due to internal reflections in the lens implant, or
debris left in the eye from the second operation?  She wants to know
the cause before considering having the other eye done.

I am presenting this information second hand, as my sister is
unfamiliar with newsgroups, and so far has not found anything on the
web.  Perhaps someone here has had this problem and can offer
suggestions. Any thoughts will be appreciated.
Please reply to the group.
TIA

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Uncle      

William Stacy - 04 May 2005 20:19 GMT
 She is now about a minus 1 diopter in that eye,
> which was what she wanted, but she is extremely bothered by
> reflections and glare from any light sources anywhere at the edges of
[quoted text clipped - 5 lines]
> debris left in the eye from the second operation?  She wants to know
> the cause before considering having the other eye done.

It's definitely due to reflections off the edges of the implant.  There
are different edge designs that give more or less reflections.

I got Tecnis implants and don't have the problem, although I do see an
occasional reflection under special conditions (very bright light
shining from about 90 dgrees to the direction of gaze), but not often.

Sounds like she should go with the Alcon or consider the Tecnis, if they
let her choose. I'd recommend shooting for zero refraction in the 2nd
eye. (I ended up about -1 in one eye and 0 in the other and am quite happy).

w.stacy, o.d.
Robert Martellaro - 04 May 2005 21:12 GMT
>My sister had a cataract removed about a month ago by her local
>ophthalmologist and the implant lens left her more nearsighted than
[quoted text clipped - 26 lines]
>Please reply to the group.
>TIA

Well, my first thought is to tell your sister to stay far away from doctor #2,
not just because of the poor result but because the second surgery should not
have taken place in the first place, at least not for the reason stated.

I doubt that doctor #1 missed by 2.50 diopters, not with technology presently
available. More likely there was a mis-understanding concerning the expected
vision and Rx power post surgery. A -3.50 result has many advantages for a
person with a historic -6.00 Rx, superior near vision without glasses compared
to those who have to wear glasses for near, with much better coordination with
the fellow eye.For those who need to have surgery due tor cataract(s) please
discuss thoroughly with your MD/OD and your optician *before* the surgery.

 

Robert Martellaro
~~~~~~~~~~~~~~~~~~
Optician/Owner
Roberts Optical
robopt@execpc.com
~~~~~~~~~~~~~~~~~~
"An expert is a person who has made all the mistakes that can be made in a very narrow field."
 - Niels Bohr
William Stacy - 04 May 2005 21:55 GMT
Good points, and I agree they were a bit hasty to "correct" the
"problem", although I tend to favor what I call "modified" or "partial"
monovision, more like -1 or -1.5 and plano. Also, I understand the
surgeons are having more trouble zeroing in on the iol powers when
people have had lasik.  It messes up their calcs, but if she hadn't had
lasik, they should have nailed it.

w.stacy, o.d.

> Well, my first thought is to tell your sister to stay far away from doctor #2,
> not just because of the poor result but because the second surgery should not
[quoted text clipped - 7 lines]
> the fellow eye.For those who need to have surgery due tor cataract(s) please
> discuss thoroughly with your MD/OD and your optician *before* the surgery.
Uncle - 05 May 2005 01:37 GMT
>Good points, and I agree they were a bit hasty to "correct" the
>"problem", although I tend to favor what I call "modified" or "partial"
[quoted text clipped - 16 lines]
>> the fellow eye.For those who need to have surgery due tor cataract(s) please
>> discuss thoroughly with your MD/OD and your optician *before* the surgery.

Thanks for your responses. The first ophthalmologist used old
technology, some hand-held instrument, and was rather rough and
careless and actually scraped my sister's cornea while measuring the
eye length. There was no misunderstanding about how she wanted to see
after the implant. His surgery was fine, just the wrong power lens.
Also she never had lasik.

Thanks again,
Uncle  
William Stacy - 05 May 2005 01:58 GMT
> Thanks for your responses. The first ophthalmologist used old
> technology, some hand-held instrument, and was rather rough and
> careless and actually scraped my sister's cornea while measuring the
> eye length.

Ouch.  That would be an ultrasound.  I was lucky enough to have the
laser interferometry, no touch method.  Much better and more accurate.
Still not very widely available. Hope she does better on the next one.

w.stacy, o.d.
Robert Martellaro - 05 May 2005 18:08 GMT
>My sister had a cataract removed about a month ago by her local
>ophthalmologist and the implant lens left her more nearsighted than
[quoted text clipped - 26 lines]
>Please reply to the group.
>TIA

Try a google search using  IOL flare glare. IOL stands for intraocular implant.
I would recommend opinions from two different doctors from different clinics or
groups if additional surgery is performed.

Just a thought, once the other eye is done the glare might not be as noticeable.
Might be wise to delay  making decisions until then, if the doctors agree.

Hope this helps

Robert Martellaro
~~~~~~~~~~~~~~~~~~
Optician/Owner
Roberts Optical
robopt@execpc.com
~~~~~~~~~~~~~~~~~~
"An expert is a person who has made all the mistakes that can be made in a very narrow field."
 - Niels Bohr
 
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