wrong lens implant after cataract surgery

[Suz25]

I think my doctor put the  close vision implant in the wrong eye, my dominant eye, and now I have blurred long distance vision when I try to see with both the close vision eye and the long vision eye.  Who do I report this to?

[marisha100]

I recently had cataract surgery with implant. My vision in the eye the surgery was perfomred, tested with glasses 20/50.  The day after surgery without glasses it tested 20/60.  A few days after it tested 20/80.  Two weeks later it tested 20/100.  It seems to be getting worse all the time.  Was told to get glasses to try to correct.  Any suggestions?

[John C Hagan III, MD, FACS, FAAO]

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[Suz25]

Your comment about communitcating is right on target, my second opinion doctor was so much better at explaining - of course it was after the fact.  Cataract surgery is done so 'routinely' I think the doctors forget about all the possibilities - the idea of mono-vision should have been well tested before the surgery.

[John C Hagan III, MD, FACS, FAAO]

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[artforartsake]

In my recent cataract surgeries, my doctor opted for some monovision, aiming for distance in my non-dominant eye and near vision in my dominant eye (with Crystalens lenses).  Apparently unlike your situation, my doctor hit target, the monovision is working as intended, and I'm functioning without glasses at all. So it can work.  

I also had some communication issues with my doctor about what would be done.  I can't say I would have done anything differently, but it would have been nice to have known in advance more fully what was planned.  And I had asked lots and lots of questions.  Some doctors aren't very good communicators.  From personal experience, I know that's true in most other professions.

[John C Hagan III, MD, FACS, FAAO]

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[kmcc]

I notice on this forum that LASIK is often recommended to correct refractive errors after cataract surgery. I wonder how many people have followed up on this and have had a successful outcome ? .

[JodieJ]

Many people with monovision do fine using their dominant eye for near vision.  When I had monovision contacts, I did just as well when I accidently switched my contacts.  (Is it possible that your distance vision is impaired because your non-dominant eye is mildly nearsighted--not great for a monovision correction. You might try wearing a contact lens to correct your non-dominant eye to plano.)

If you really can't adjust to distance vision in your non-dominant eye and near vision in your dominant eye, then you'll need to do something about it.  In your place, I'd get either LASIK or PRK done on my dominant eye only to correct it to plano.  This would give you a mini-monovision correction (since your non-dominant eye is mildly nearsighted), which you might find very satisfactory.  (If not, you could look into the possibility of a refractive procedure or a contact lens for your non-dominant eye.)

[John C Hagan III, MD, FACS, FAAO]

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[Lerbea]

I wear glasses to correct my lens IOL status.  I chose not to do lasik as it was done to correct the astigmatism along with the cataract surgery.  I was in worse shape after this and have thus had one IOL exchange with the 2nd coming up, with both of these by a  totally different doctor.

[John C Hagan III, MD, FACS, FAAO]

It sounds like you opted for "monovision" and that is to try and give the best possible vision without glasses however it is not something that is guarenteed or implied. You can use the search feature to read about the advantages and disadvantages of monovision.

If you can see good with glasses or if the problem is correctable with lasik or contacts then there's nothing to report. Even with monovision or multifocal IOLs surgeons can never guarentee that patients won't have to have glasses some of the time or additional lasik surgery.

JCH MD

[peakhope]

I'm very sorry to hear that you're not happy with your outcome. I'm not a doctor, but recently had IOL implants myself. If you read this forum (and especially if you search for rezoom), you will find many people who have had far worse outcomes, including vision problems that cannot be corrected at any price.

It sounds like everything went as the doctor planned (within a reasonable margin of unpredictability), and that overall you did have a "successful" result. The problem seems to be that there was a serious a lack of communication before the procedure. You should have known exactly what he was planning, and could have objected at that point. Only you and he know what was said (unless you have things in writing), so there is really no way for us or anyone else to know where the communication breakdown occurred.

Hopefully if nothing else, your story will help other people realize that they need to fully understand what is planned. Not just the brand names and numbers, but how the result will actually work and feel. And hopefully by letting the doctor know that you are unsatisfied, s/he will do a better job with other patients in the future.

Prior to surgery, my doctor told me that if I needed further laser correction after the implants, that he would give me a very steep discount on it. Perhaps that's because I was a cash patient, so he knew he would be saving a lot on paperwork costs. You might try to persuade (not force) your doctor to give you a discount...assuming you still trust him/her, and that s/he is an excellent lasik surgeon.

Again, I am really sorry to hear about your situation, and I don't want to minimize your frustration and disappointment. I just hope that you will find a way to correct the minor nearsightedness in the one eye, and that your brain will quickly adjust to the dominant/near lens, and thus that you will end up with excellent overall vision.

[Suz25]

I did discuss it with my surgeon, he said the operation was a success (cataracts gone, eyes healthy), suggested glasses, contacts or Lasik which I would have to pay for.  I went for a second opinion, yes, the near lens is in my dominant eye (not recommended), and the far eye is slightly nearsighted - another wrong choice?  Again, contact lens or Lasik are my options.
I have lived in two retirement communities and never heard of this extreem problem.
I still feel the first doctor should be censured

[John C Hagan III, MD, FACS, FAAO]

You don't report it to anyone. you discuss it with your surgeon. If you aren't satisfied with the explanation then you see another surgeon for a second opinion.

Picking the "right" IOL power is not an exact science and under/over corrections are common.

If its correctable with glasses its really not unexpected.

JCH MD