Cataract surgery after effect

[Peter110]

I had a cataract removed from my right eye 10 days ago and a toric lense implanted to correct a life-long far-sightendeness and astigmatism problem. By all accounts, the front of the eye is crystal clear and the operations was a success. However, my vision keeps fluctuating between 20/40 and 20/100, and I see much better objects that are close than objects that are far. I have the following questions:
1. Could this be caused by partial detachment of the vitreous, as suggested by my retina specialist?
2. If so, how long should I wait before I allow surgical detachment of the vitreous, if at all?
3. What other options do I have?
4. Might the cataract surgery have induced myopia in my right eye? Is this correctable with glasses?
3. My left eye is free of cataract but the doctor recommended that it too undergo lens replacement, like the right eye. What is your suggestion, considering that (a) my left eye has traditionally been much weaker than my right eye, (b) it too suffers from astigmatism; and (c) I have strabismus, and use primarily my right eye, the left eye serving primarily for peripheral vision?

[Michael J Kutryb, MD]

The most likely cause of less than desired distance vision is a residual refractive error either myopia or astigmatism or both.  Both can be corrected with glasses.  If the vitreous detachment is causing blurring of the vision, your surgeon would easily see it and could tell you about that. I have seen it happen before but residual refractive error is much, much more likely to be the problem.  Regarding the other eye, it there is a major refractive inbalance between the eyes, it can make you rather dizzy and uncomfortable and the  only way to deal with it, is usually contact lenses or glasses.  If you can simply wear a contact lens and everything goes well, then you could put off surgery on the second eye since it doesn't have a cataract from what you say.  Now if you can't wear a contact lens (which is very likely the case) then you may have to seriously consider cataract surgery. This should all be carefully discussed BEFORE the first eye cataract surgery so you know exactly what to expect.

Talk the case over with your surgeon - it should be fairly easy to work out the best answer for you.  Find out what your current refraction is in the surgery eye and that will answer your blurriness question.  Good Luck.

MJK MD

[Peter110]

Dear Dr. Kutryb: This has been extremely helpful and reassuring. I will do as you suggest and let you know the results. Many thanks, Peter