On 7/8/05 7:45 PM, in article 42CF3A55.C08D98A1@myrealbox.com, "The Real
Bev" <bashley@myrealbox.com> wrote:

By the way, one can easily have glaucoma WITHOUT increased pressure. This is
common, and know as "normal tension glaucoma". Diagnosis is based on
cup/disk assymetry, as well as abnormal visual fields. A common
misconception, that your story supports, is the glaucoma requires elevated
pressure, which is not true in about 10 of glaucoma cases.

Just as common a treatment issue is people being treated for glaucoma for
years because they had one slightly elevated pressure. Some people have
ocular hypertension (elevated pressure) without any damage, so there is
really no "glaucoma", but are being treated as such. Or, some people get
high reading leaning forward into the instrument, and really don't have high
pressure when measured in the upright peosition, so they are getting treated
for a measurement artifact.

Just some more information for folks out there.

Now, I'm not saying your mom actually had glaucoma, or that the new doctor
was wrong - just more info.

I think you mean emmetropia.  Nobody in their right mind would choose
hyperopia post cataract. If she ended up -.25 to -1.50 myopic, that was
a reasonable outcome; if more than that, then I'd agree that an error
was made.

w.stacy, o.d.

Hello All,

First let me thank all of you for the responses. Here are my comments.

I am not against glasses per se; but if they are not needed or are
forced on someone because of an error in judgment or laxness as a result
of a surgery, that is particularly vexing. The question is not whether
glasses will fix the problem (they will) but whether the problem can be
corrected surgically. It is virtually certain that the correct choice of
IOL would have avoided the problem and left me without the need for
glasses (except for reading).   A very large percentage of cataract
surgeries end up with this outcome (do a google to see results). With
the high accuracy of the Zeiss IOLmaster, and formula of Holladay,
outcomes are better than ever. Given the the previous evidence of the
surgery of the person on another eye (my case) only adds to the data. Am
I unreasonable to try to fix the problem surgically. Perhaps, but I have
a little quotation on my wall the helps me sometimes when I have a
particularly difficult problem to solve. See next paragraph.

"The reasonable man adapts himself to the world; the unreasonable one
persists in  trying to adapt the world to himself.  Therefore all
progess depends on the unreasonable man." George Bernard Shaw.

Yes glasses are wonderful (enter tongue in cheek mode). Now when I get
up in the morning to shave, go jogging, play racquetball go for a drive,
walk in my yard, etc. I must make sure I take this wonderful device
along.  And if I need to protect my eyes from UV rays then I need to
have special prescriptions made. (End tongue in cheek). When I had my
first cataract surgery they prescribed glasses because untreated right
eye was myopic. So even though left eye was plano I was told to use
glasses. They recommend progressives. After a week or so they ended up
in the drawer and I made my way around with the good left eye unaided
optically. It worked okay. Looks like a repeat of that situation.

Regarding going to a medical school for advice and surgery, that is
exactly what I did because of the good reputation of the school. And,
remember, they did a good job on my first eye, so why shouldn't I go
back? Someone once said " go to a cataract surgeon that is not too young
or old and does lots of surgeries" Sorry, but that could be the wrong
advice as the surgeon could be getting lax from all that work.  Look at
all the cataract surgeries down in Florida, many of which are not needed
and have poor outcomes. Because of patient's age, they rarely complain.
(See Bev's comments earlier in thread). My mother had exactly that
happen to her... needless cataract surgery. I was not there to advise as
my sister did the advising down in Florida, wrongly as it turned out.

Dr. Robins is probably on target saying that few surgeons would explant
because of a 1/2 D error. But it will be interesting to see if I can
find one; and at least discuss the possibility of a correct outcome. I
need to hear from a real explant surgeon about the risks. (BTW I found
out too late that a regular dentist often does a terrible job at root
canals. My dentist wrecked my tooth and it had to be removed. From then
on I used a specialist without problems. Perhaps a similar situation can
be found with IOL explant specialist). Maybe I can be the guinea pig?
<g>

Again, thanks for all the replies.

George Steber Ph.D, Emeritus Professor

PS. Dr. Robins, I am an electrical engineer with over 50 products
designed ranging from video processing systems (including remote
radiology), code processors and breakers, the VPUs in Cape Kennedy,
Houston and other locations, as well as more practical devices like the
"stud seeker" in your local hardware store. My latest device, a "wire
stripper with non-contact voltage alert" hit Home Depot on father's day.
It was my 18th patent. Early in life I transferred from medical school
to engineering because of all the rote memorization and would rather
rely on the laws of physics and principles of engineering. Soon
thereafter one of my colleagues left engineering and got a medical
doctorate and is now an opthalmologist; lost track of him. Sounds like
that is what you did. If things had turned out a little differently for
me, who knows, I might have been a cataract surgeon, although I did lean
towards brain surgery. Surgery is much more advanced and interesting
today with all those wonderful gadgets <g>.

.> > 15.5 which would have matched both eyes and made them both
slightly
.> > myopic. When I brought this up with him, he was very defensive and
said
.> > it would be okay and that a 0.5D difference was negligible. Well
it
is
.> > not negligible to me and I can see that right eye is not as sharp
as the
.> > left eye. Also nothing seems to be in focus in right eye now
unless
it
.> > is very far away.  He said to use both eyes and not compare vision
from
.> > each other. That seems like good advice, but with large floaters
.> > occasionally left eye is blocked and must revert to right eye
which
may  be blurry.

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