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Medical Forum / General / Vision / October 2006Disappointing results from cataract surgery
It has been nearly two months since cataract surgery. The surgeon declared the surgery "perfect" at the end of the surgery. I had gone into the surgery in good health and with modest myopia. The surgery was on the left eye and the intent was distance correction. The experience afterward was not the experience so frequently heard. There were no complications and while there was a very tiny swelling of the corneal surface detected two weeks after surgery, that too has vanished. There persists, and this is true since about the third or fourth day after surgery, a blurriness at all distances; and with distance, as for example the crosswalk signs (cross/don't cross) on the street, two images for distant objects. I wondered if anyone else had had similar experiences. You see double images? Did you mention these symptoms to the surgeon after the last refraction test? I had double images for about two weeks after surgery, attributed to a "crease" or bend of the IOL, but symptoms diminished slowly thereafter. What kind of surgery did you have? By that I mean, was it "stitch-less" or did you have stiches? George > It has been nearly two months since cataract surgery. The surgeon > declared the surgery "perfect" at the end of the surgery. I had gone [quoted text clipped - 8 lines] > street, two images for distant objects. > I wondered if anyone else had had similar experiences. Stitch-less. And yes it has been mentioned to the Surgeon only two days ago. There a scanning test on Tuesday to come. I've come across others for whom a good resolution took months and sometimes some intervention. > You see double images? Did you mention these symptoms to the surgeon after > the last refraction test? I had double images for about two weeks after [quoted text clipped - 14 lines] > > street, two images for distant objects. > > I wondered if anyone else had had similar experiences. >It has been nearly two months since cataract surgery. The surgeon >declared the surgery "perfect" at the end of the surgery. A surgically perfect surgery is different than ending up being "plano DS" in the distance. A lot of (anatomically) "perfect retinal detachment surgeries" end up with 20/400 vision. >I had gone into the surgery in good health and with modest myopia. >The surgery was on the left eye and the intent was distance [quoted text clipped - 5 lines] >distances; and with distance, as for example the crosswalk signs >(cross/don't cross) on the street "Blurriness" is very subjective. What is your uncorrected and best corrected visual acuity and/or contast sensitivity? >two images for distant objects. Is this with the with the best possible distance refraction/glasses in front of your eyes or uncorrected? This could be something as simple as uncorrected astigmatism that you perhaps had before (and now after) surgery. This is true. I did have an astigmatism before the surgery. I have just had a prescription for that eye and the results are no different. > >It has been nearly two months since cataract surgery. The surgeon > >declared the surgery "perfect" at the end of the surgery. [quoted text clipped - 24 lines] > as uncorrected astigmatism that you perhaps had before (and now after) > surgery. > It has been nearly two months since cataract surgery. The surgeon > declared the surgery "perfect" at the end of the surgery. I had gone [quoted text clipped - 8 lines] > street, two images for distant objects. > I wondered if anyone else had had similar experiences. You need to have a careful refraction so that any refractive error can be cleared up with glasses, etc. What kind of IOL did you get (brand name, etc)? w.stacy, o.d. That's, hopefully, much better than the un-careful refraction exam <grin>. > You need to have a careful refraction so that any refractive error can > be cleared up with glasses, etc. What kind of IOL did you get (brand > name, etc)? > > w.stacy, o.d. Right. I don't know how to put it delicately. Refraction is as much an art as it is a science. Some people have "the touch" to do it right and some don't. It's kind of mysterious, almost like voodoo. Anyway, my point was more or less: if at first you don't succeed... w.stacy, o.d. > That's, hopefully, much better than the un-careful refraction exam <grin>. > [quoted text clipped - 3 lines] >> >>w.stacy, o.d. Do you mean that there might have been a poor lense selection by the surgeon; that there is no, shall we say, mathematical determination of the specific lense to be implanted and this can result in probems? > Right. I don't know how to put it delicately. Refraction is as much an > art as it is a science. Some people have "the touch" to do it right and [quoted text clipped - 10 lines] > >> > >>w.stacy, o.d. There is a, to use your phrase, a mathematical determination of the correct IOL power based on the results of your eye measurement test taken prior to surgery. The eye measurement is usually via a ultra sonic or laser system that then puts the resulting data into a mathematical model to find the right IOL. But it is not perfect and there is always a fudge factor involved that the cataract surgeon may use depending on their prior experience. They can also goof, under the pressure of trying to get too many patients through, that they may also get it wrong. You may want to discuss this possibility with your surgeon, but he/she may get a bit testy as they may see a law suit on the horizon and they don't want to incriminate themselves. George > Do you mean that there might have been a poor lense selection by the > surgeon; that there is no, shall we say, mathematical determination of > the specific lense to be implanted and this can result in probems? There could be, but I'm still waiting to know what lens type they implanted. If it was a complex lens type (multifocal or "focussing" lens), then it is understandable that you are unhappy. I am seriously thinking of mounting an online fight against those despicable lenses. w.stacy, o.d. > Do you mean that there might have been a poor lense selection by the > surgeon; that there is no, shall we say, mathematical determination of [quoted text clipped - 14 lines] >>>> >>>>w.stacy, o.d. how was your vision in the left eye before your surgery? is it better now? sometimes patients, and doctors, believe that poor vision in an eye is caused by cataracts just because they see that a cataract is present. however, after the surgery, it becomes apparent that the poor vision was due at least in part to something else. perhaps you had an expectation of "perfect" vision after the surgery which is really an unreasonable expectation. your complaint sounds to me like you still have some uncorrected astigmatism. if you had astigmatism prior to surgery you more than likely still have it since it is not easily remedied by intraocular lens implantation. you mention that you just got a prescription for your operated eye and the blurriness is still there. who did the refraction for your new prescription? the surgeon? as was mentioned by Dr. Stacy, it takes much practice to become a good refractionist. oftentimes surgeons are not the best refractionists. regardless of who did the refraction for your new prescription I would recommend having a second refraction and telling the doctor exactly what your complaint is. he/she can see how much residual refractive error remains after surgery and also tell you if your new prescription glasses are correct or not. and as mentioned earlier, there may be other issues that aside from refractive error, and aside from your cataract, that causes blurry vision. =================== > It has been nearly two months since cataract surgery. The surgeon > declared the surgery "perfect" at the end of the surgery. I had gone [quoted text clipped - 8 lines] > street, two images for distant objects. > I wondered if anyone else had had similar experiences. |
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